Odds of heart attack


Heart Health and Aging

How Does the Heart Work?

Your heart is a strong muscle that pumps blood to your body. A normal, healthy adult heart is about the size of your clenched fist. Just like an engine makes a car go, the heart keeps your body running. The heart has two sides, each with a top chamber (atrium) and a bottom chamber (ventricle). The right side pumps blood to the lungs to pick up oxygen. The left side receives blood rich with oxygen from the lungs and pumps it through arteries throughout the body. An electrical system in the heart controls the heart rate (heartbeat or pulse) and coordinates the contraction of the heart’s top and bottom chambers.

How Your Heart Changes with Age

People age 65 and older are much more likely than younger people to suffer a heart attack, to have a stroke, or to develop coronary heart disease (commonly called heart disease) and heart failure. Heart disease is also a major cause of disability, limiting the activity and eroding the quality of life of millions of older people.

Aging can cause changes in the heart and blood vessels. For example, as you get older, your heart can’t beat as fast during physical activity or times of stress as it did when you were younger. However, the number of heartbeats per minute (heart rate) at rest does not change significantly with normal aging.

Changes that happen with age may increase a person’s risk of heart disease. A major cause of heart disease is the buildup of fatty deposits in the walls of arteries over many years. The good news is there are things you can do to delay, lower, or possibly avoid or reverse your risk.

The most common aging change is increased stiffness of the large arteries, called arteriosclerosis (ahr-teer-ee-o-skluh-roh-sis), or hardening of the arteries. This causes high blood pressure, or hypertension, which becomes more common as we age.

High blood pressure and other risk factors, including advancing age, increase the risk of developing atherosclerosis (ath-uh-roh-skluh-roh-sis). Because there are several modifiable risk factors for atherosclerosis, it is not necessarily a normal part of aging. Plaque builds up inside the walls of your arteries and, over time, hardens and narrows your arteries, which limits the flow of oxygen-rich blood to your organs and other parts of your body. Oxygen and blood nutrients are supplied to the heart muscle through the coronary arteries. Heart disease develops when plaque builds up in the coronary arteries, reducing blood flow to your heart muscle. Over time, the heart muscle can become weakened and/or damaged, resulting in heart failure. Heart damage can be caused by heart attacks, long-standing hypertension and diabetes, and chronic heavy alcohol use.

Age can cause other changes to the heart. For example:

  • There are age-related changes in the electrical system that can lead to arrhythmias—a rapid, slowed, or irregular heartbeat—and/or the need for a pacemaker. Valves—the one-way, door-like parts that open and close to control blood flow between the chambers of your heart—may become thicker and stiffer. Stiffer valves can limit the flow of blood out of the heart and become leaky, both of which can cause fluid to build up in the lungs or in the body (legs, feet, and abdomen).
  • The chambers of your heart may increase in size. The heart wall thickens, so the amount of blood that a chamber can hold may decrease despite the increased overall heart size. The heart may fill more slowly. Long-standing hypertension is the main cause of increased thickness of the heart wall, which can increase the risk of atrial fibrillation, a common heart rhythm problem in older people.
  • With increasing age, people become more sensitive to salt, which may cause an increase in blood pressure and/or ankle or foot swelling (edema).

Other factors, such as thyroid disease or chemotherapy, may also weaken the heart muscle. Things you can’t control, like your family history, might increase your risk of heart disease. But, leading a heart-healthy lifestyle might help you avoid or delay serious illness.

What Is Heart Disease?

Heart disease is caused by atherosclerosis (ath-uh-roh-skluh-roh-sis), which is the buildup of fatty deposits, or plaques, in the walls of the coronary arteries over many years. The coronary arteries surround the outside of the heart and supply blood nutrients and oxygen to the heart muscle. When plaque builds up inside the arteries, there is less space for blood to flow normally and deliver oxygen to the heart. If the flow of blood to your heart is reduced by plaque buildup or is blocked if a plaque suddenly ruptures, it can cause angina (chest pain or discomfort) or a heart attack. When the heart muscle does not get enough oxygen and blood nutrients, the heart muscle cells will die (heart attack) and weaken the heart, diminishing its ability to pump blood to the rest of the body.

Find out more about heart attacks.

Signs of Heart Disease

Early heart disease often doesn’t have symptoms or the symptoms may be barely noticeable. That’s why regular checkups with your doctor are important.

Contact your doctor right away if you feel any chest pain, pressure, or discomfort. However, chest pain is a less common sign of heart disease as it progresses, so be aware of other symptoms. Tell your doctor if you have:

  • Pain, numbness, and/or tingling in the shoulders, arms, neck, jaw, or back
  • Shortness of breath when active, at rest, or while lying flat
  • Chest pain during physical activity that gets better when you rest
  • Lightheadedness
  • Dizziness
  • Confusion
  • Headaches
  • Cold sweats
  • Nausea/vomiting
  • Tiredness or fatigue
  • Swelling in the ankles, feet, legs, stomach, and/or neck
  • Reduced ability to exercise or be physically active
  • Problems doing your normal activities

Problems with arrhythmia are much more common in older adults than younger people. Arrhythmia needs to be treated. See a doctor if you feel a fluttering in your chest or have the feeling that your heart is skipping a beat or beating too hard, especially if you are weaker than usual, dizzy, tired, or get short of breath when active.

If you have any signs of heart disease, your doctor may send you to a cardiologist, a doctor who specializes in the heart.

To learn more about heart disease, visit the National Heart, Lung, and Blood Institute.

What Can I Do to Prevent Heart Disease?

There are many steps you can take to keep your heart healthy.

Try to be more physically active. Talk with your doctor about the type of activities that would be best for you. If possible, aim to get at least 150 minutes of physical activity each week. Every day is best. It doesn’t have to be done all at once.

Start by doing activities you enjoy—brisk walking, dancing, bowling, bicycling, or gardening, for example. Avoid spending hours every day sitting. For more information on how to exercise safely, check out Go4Life®. This exercise and physical activity campaign from the National Institute on Aging (NIA) has exercises, motivational tips, and free video and materials. Go4Life is designed to help you fit exercise and physical activity into your daily life.

If you smoke, quit. Smoking is the leading cause of preventable death. Smoking adds to the damage to artery walls. It’s never too late to get some benefit from quitting smoking. Quitting, even in later life, can lower your risk of heart disease, stroke, and cancer over time.

Follow a heart-healthy diet. Choose foods that are low in trans and saturated fats, added sugars, and salt. As we get older, we become more sensitive to salt, which can cause swelling in the legs and feet. Eat plenty of fruits, vegetables, and foods high in fiber, like those made from whole grains. Get more information on healthy eating from NIA. You also can find information on the Dietary Approaches to Stop Hypertension (DASH) eating plan and the U.S. Department of Agriculture’s Food Patterns.

Keep a healthy weight. Balancing the calories you eat and drink with the calories burned by being physically active helps to maintain a healthy weight. Some ways you can maintain a healthy weight include limiting portion size and being physically active. Learn more about how to maintain a healthy weight from NIA.

Keep your diabetes, high blood pressure, and/or high cholesterol under control. Follow your doctor’s advice to manage these conditions, and take medications as directed.

Don’t drink a lot of alcohol. Men should not have more than two drinks a day and women only one. One drink is equal to:

  • One 12-ounce can or bottle of regular beer, ale, or wine cooler
  • One 8- or 9-ounce can or bottle of malt liquor
  • One 5-ounce glass of red or white wine
  • One 1.5-ounce shot glass of distilled spirits like gin, rum, tequila, vodka, or whiskey

Manage stress. Learn how to manage stress, relax, and cope with problems to improve physical and emotional health. Consider activities such as a stress management program, meditation, physical activity, and talking things out with friends or family. To learn more about stress management techniques, visit the National Center for Complementary and Integrative Health.

To learn more about making heart-healthy lifestyle changes, visit the National Heart, Lung, and Blood Institute.

The Future of Research on Aging and the Heart

Adults age 65 and older are more likely than younger people to suffer from cardiovascular disease, which is problems with the heart, blood vessels, or both. Aging can cause changes in the heart and blood vessels that may increase a person’s risk of developing cardiovascular disease.

To understand how aging is linked to cardiovascular disease so that we can ultimately develop cures for this group of diseases, we need to first understand what is happening in the healthy but aging heart and blood vessels. This understanding has advanced dramatically in the past 30 years.

Learn more about The Heart Truth®, a national heart disease awareness campaign for women from the National Heart, Lung, and Blood Institute.

Today, more than ever, scientists understand what causes your blood vessels and heart to age and how your aging cardiovascular system leads to cardiovascular disease. In addition, they have pinpointed risk factors that increase the odds a person will develop cardiovascular disease. They are learning much more about how physical activity, diet, and other lifestyle factors influence the “rate of aging” in the healthy heart and arteries. The aging of other organ systems, including the muscles, kidneys, and lungs, also likely contributes to heart disease. Research is ongoing to unravel how these aging systems influence each other, which may reveal new targets for treatments.

In the future, interventions or treatments that slow accelerated aging of the heart and arteries in young and middle-aged people who seem to be healthy could prevent or delay the onset of heart disease, stroke, and other cardiovascular disorders in later life. Some interventions that we already know slow the rate of aging in the heart and arteries include healthy eating, exercise, reducing stress, and quitting smoking. The more we understand the changes that take place in cells and molecules during aging, for example, the closer we get to the possibility of designing drugs that target those changes. Gene therapies can also target specific cellular changes and could potentially be a way to intervene in the aging process. While waiting for these new therapies to be developed, you can still enjoy activities, like exercise and a healthy diet, that can benefit your heart.

Read about this topic in Spanish. Lea sobre este tema en español.

For More Information About Heart Health

American Heart Association
1-800-242-8721 (toll-free)

National Heart, Lung, and Blood Institute
[email protected]

National Library of Medicine

This content is provided by the National Institute on Aging (NIA), part of the National Institutes of Health. NIA scientists and other experts review this content to ensure that it is accurate, authoritative, and up to date.

Content reviewed: June 01, 2018

Blood pressure and heart rate go hand in hand in most people’s minds. After all, these two vital signs usually are measured at the same time at the doctor’s office.

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But each measures distinctly different factors related to your heart health. Blood pressure is the force of blood flowing against the walls of your arteries, while heart rate — sometimes called pulse — is the number of times your heart beats every minute.

Below, cardiologist Luke Laffin, MD, explains some key differences — and busts some common myths along the way.

1. Blood pressure and heart rate are always linked

False: It is true that blood pressure and heart rate often rise and fall together, Dr. Laffin says. When you face danger, for example, your blood pressure and pulse may both jump upward at the same time. However, if your heart rate rises, that doesn’t automatically mean your blood pressure will rise — or vice versa.

“When the two are disconnected, you may be looking at a specific problem,” Dr. Laffin says. “For example, if you are dehydrated, bleeding or have a severe infection, blood pressure typically decreases and heart rate increases.”

2. Blood pressure and heart rate have “normal” target numbers

False: There are guidelines, but what’s normal varies from person to person.

Optimal blood pressure typically is defined as 120 mm Hg systolic — which is the pressure as your heart beats — over 80 mm Hg diastolic — which is the pressure as your heart relaxes. For your resting heart rate, the target is between 60 and 100 beats per minute (BPM).

Keep in mind that heart rate and blood pressure are a customized fit. You need to work with your doctor to establish a baseline that’s normal for you.

3. A low pulse or blood pressure always indicates a problem

False: What’s healthy for one person may indicate danger for another. For example, a fit person may have a resting heart rate in their 50s or, in some cases, even their 40s. “It can actually be a sign of being in really good shape,” Dr. Laffin says.

Low blood pressure can be a bit trickier, especially in older patients and those with heart disease. If you’re in danger from low blood pressure, your body will tell you. “It’s really about how you feel,” Dr. Laffin says. “Are you feeling weak? The numbers on their own don’t tell the story; it’s the numbers paired with the symptoms you may have.”

4. High blood pressure is more dangerous than a high heart rate

True: Again, what’s considered normal varies. But Dr. Laffin says there is enough clinical evidence to suggest that when blood pressure is even a little over your typical average over time, the risk for heart disease and stroke go up. The physical effects of high blood pressure take their toll on your blood vessels.

“Essentially, for each increment of 20 mmHg over 115 mmHg systolic, your risk of heart attack, stroke, heart failure or chronic kidney disease doubles,” Dr. Laffin says.

Elevated heart rate can be a sign of danger, too, but the cause-effect relationship is not so clear. “Studies show that people who have faster baseline heart rates are more likely to have cardiac problems and premature cardiac death,” Dr. Laffin says. “But we’re not sure whether that is the cause of the problem or just a sign of what’s going on. The most common cause of a high resting heart rate is being deconditioned (in other words, out of shape).”

5. When you measure matters

True: To measure your resting heart rate and blood pressure, pick a reliable and reproducible time, Dr. Laffin advises. Ideally, check in the morning before medications and occasionally in the evening, around dinner time. Don’t take your readings right after exercising — unless you’re trying to establish a baseline for what’s called active blood pressure and heart rate.

During readings, you want to be in a resting position with your legs uncrossed. Many people don’t realize that crossing your legs while taking a reading may cause an eight to 10 point increase in systolic blood pressure.

Which measure is more important? This depends on your health, too. For patients with atrial fibrillation, heart rate might be more important to watch, but many other heart diseases depend more on blood pressure. To be safe, measure both.

“Almost all automated kits you buy at a store provide blood pressure and pulse on one readout,” Dr. Laffin says. “It’s convenient — and knowing both numbers helps better understand how to make lifestyle and medication adjustments.”

6. The faster the heart rate, the shorter the lifespan

True: In a large study of people going for a health checkup in China, those who had a high-normal resting heart rate of 80 bpm to 90 BPM had a 40 percent shorter lifespan than those with a desirable heart rate of 60 BPM to 69 BPM.

However, the good news is that 15 minutes to 30 minutes of daily moderate exercise, such as brisk walking, could eliminate the increased mortality and reverse the life-span loss, the researchers say.

The study underlines the important role that physical activity can play in keeping your heart healthy — and giving you a longer life, Dr. Laffin says.

“Even moderate activity has benefits,” he says. “So there is no longer any reason to stay on the couch.”

Checking Your Blood Pressure

Blood pressure is the force of the blood against the walls of your arteries as your heart pumps it around your body. There are two ways it’s measured:

Systolic blood pressure. This is the pressure in your arteries when your heart squeezes.

Diastolic blood pressure. It’s the pressure in your when your heart is relaxed, between heartbeats.

Normal blood pressure for an adult, when you’re at rest, is less than 120 over less than 80. The 120 is the systolic pressure. The diastolic pressure is 79.

High blood pressure, also called hypertension, is a blood pressure reading of 130/80 or higher.

Years of high blood pressure can stiffen and narrow your artery walls, which blocks the blood flow to your heart. It can lead to heart disease or heart attack.

Your blood pressure may go up or down depending on your age, heart condition, emotions, activity, and the medications you take. One high reading doesn’t mean you have high blood pressure. You need to measure it at different times while you’re resting to find out your typical numbers.

Top 6 Health Numbers To Know After Age 40

Hitting 40? What are the numbers you need to track to stay healthy and on top of things?

Anyone in their mid-30s or younger is probably not reading this post. It’s only when the big FOUR-OH milestone is approaching that you find yourself reading articles and fretting that you’re reaching a turning point in life. Is it the end of the beginning or the beginning of the end? At the very least 40 heralds some noticable physical changes; a few more gray hairs, the need for reading glasses and the start of wrinkles around the eyes.The mirror can tell you how many gray hairs have crept onto your cranium. But those are the numbers you should track to stay looking and feeling young. Dye the doo if you wish, but don’t ignore the real health indicators – those affecting your heart.

Top 6 Health Numbers To Know After 40

The following six measurements are the main numbers to watch as you reach your big Four Zero.

1) Blood Pressure

This number should top your priority list. It is the best indicator of how well your heart is functioning.

What exactly is blood pressure?

Your arteries carry blood throughout your body. The pressure in your arteries as the blood flows through them is your blood pressure. It is measured and shown in two numbers.The first number is the amount of pressure present when your heart beats, pushing the blood through the arteries. This is your systolic blood pressure.The second number measures the pressure when your heart relaxes between beats. This is your diastolic blood pressure.Both are measured in mmHg (millimeters of mercury.) For example, 120/80mmHg. This reading is commonly stated as “120 over 80.”This is one area where we can “beat the clock” a bit. If you can maintain a blood pressure of 115/75, this will keep your body feeling and performing eight years younger than the average person.

What should your blood pressure number be?

A healthy blood pressure reading is below 140/85mmHg. Ideally, it will be 115 over 75. Notify your physician if your top number ever exceeds 140, or your bottom number reaches 90.The chart below explains the categories.

Normal – Congrats, you’re as healthy as a horse, keep doing what you’re doing!Prehypertension and Hypertension Stage 1 – These stages are a warning sign. It means your BP is not that good and may increase to a dangerous level.Hypertension Stage 2 – You’re already in a major risk group, unfortunately. Your BP is not in good shape and you can easily get dragged into a hypertensive crisis. The good news is, you can start taking drugs and do tiny changes to recover from this stage.Hypertensive Crisis – It means your BP is really high. If this is your regular average BP and your doctor knows about it, find out what you can do to lower it! If you just took a reading and it’s much higher than usual, reach out to medical assistance now.

2) Resting Heart Rate

When you are at rest, your heart should be too. A rapid heart beat while at rest is an indicator your heart is working harder than it should. This is closely tied with high blood pressure and other possible health problems.

A healthy resting heart rate is usually around 60 beats per minute. It should be in this range when you first get out of bed.

3) Cholesterol

The good, the bad, and the ugly. Cholesterol levels are measuring different types of fats in the blood. Some you want, some you don’t. Cholesterol itself is actually a nutrient, but it’s also a type of fat. This makes cholesterol both necessary and deadly. Too much of the wrong kind, and you are at risk of a heart attack.

LDL – This is the bad stuff. It’s basically plaque in your arteries. As it builds up, it blocks blood flow and causes heart attacks and strokes.HDL – This is the good stuff. HDL cholesterol helps clean up the LDL. It clears the bad stuff out of your arteries.Triglycerides – This is the fat in your blood. It’s what is left over and stored after eating to give your body energy. They are the main type of fat in the body.Combined, these three numbers create your lipid profile score. Individual numbers should be examined to determine your current health risks.

What’s Your Desired Cholesterol Number?

Your optimal number will vary depending on gender and your overall risk for heart disease.LDL – Ideally, this number will be 100 or lower. However, if you are at high risk for heart disease, 70 is your desired level. If you have no risk factors, 100-129 is considered healthy. LDL levels greater than 190 are always considered very high.HDL – Unlike LDL, which usually needs to be lowered, the concern for this number is that it doesn’t get too low. Optimal levels are 60 mg/dL and above. Unhealthy HDL levels are below 40 mg/dL for men and below 50mg/dL for women.Triglycerides – Triglycerides levels of less than 150 mg/dL are considered healthy. Ideal is 100 mg/dL or less. Levels over 200 mg/dL are considered high.

4) Blood Sugar

No, this is not a measurement of how sweet you are. It measures the amount of glucose (a type of sugar) in your blood. This glucose is found in carbohydrates, and serves as the main source of energy for your body.

Blood sugar levels normally fluctuate. They will increase after you eat. The danger occurs when glucose levels get too high, and remain at this elevated level over an extended period of time. This can cause damage to your blood vessels, kidneys, eyes, and nerves.Blood sugar tests are performed to detect diabetes and pre-diabetes, and to monitor diabetes. Another test, the A1C, provides an index of average blood glucose for the previous three to four months so it can be more representative than a spot test.

What is your optimal blood sugar level?

Healthy readings from a Fasting Blood Sugar (FBS) test are less than 100 milligrams/deciliter, but not lower than 40 mg/dL. A1C should be less than 7.0%.

5) C-Reactive Protein (CRP)

A measurement of the level of this protein in your body indicates the amount of inflammation present. Inflammation has been shown to be associated with diabetes, high blood pressure, and heart disease. Like hypertension, high levels of CRP can be a silent killer. It can produce no external symptoms to warn you of its presence, but can eventually lead to serious health problems. Keeping an eye on this protein level can help identify potential risks. A simple blood draw and lab work are completed to perform this test.

What’s your desired CRP Number ?

Normal CRP levels are less than 1.0mg/dL

CRP levels lower than 1.0 mg/L – low risk of developing cardiovascular disease.CRP levels between 1.0 and 3.0 mg/ – average risk of developing cardiovascular disease.CRP levels higher than 3.0 mg/L – high risk of developing cardiovascular disease (about 25% of Americans fall into this category).

6) Waist Size

How does your pants size affect your heart?

Your waist size is a major indicator of your current health. This number can even be a more accurate indicator of heart health than your weight or BMI (body mass index, which measures your weight in relation to your height.)It’s also an easy one to monitor. You don’t need a doctor. You don’t have to go to a lab. You don’t have to endure any needles. All you need is a measuring tape.

Use your size at your belly button for this measurement. For women, a healthy number is less than 36 inches. For men, it’s less than 40 inches. A good rule of thumb: The number should be less than half your height.Numbers greater than these increase your risk of high blood pressure, cardiovascular disease, and diabetes. In fact, research has shown that your risk for heart disease increases 15% with a four-inch increase in waist size.

Know Your Personal Health Numbers – Summary

NumberHealthy RangeBlood Pressure< 140/85 115/75 is idealResting Heart RateAround 60 beats per minuteCholesterolLDL <100, HDL >60, Triglycerides <100Blood Sugar<100, no lower than 40C-Reactive Protein/Inflammation<1.0Waist SizeWomen: <36 inches Men: <40 inches

How To Keep Your Numbers On Track

While we can’t turn back the clock, or stop it from racing forward, we can be proactive in our aging process. With proper steps you can monitor, track, and make changes to each of these numbers.Monitoring empowers you, keeps you in touch with your doctor, alerts you to early warning signs of any health problems and keeps you moving in the right direction. Tracking lets you know what you need to change and how your changes are affecting your health numbers. Making simple changes to your lifestyle, diet or medications can drastically affect these numbers and decrease health risks.

When And How To Check Your Personal Health Numbers

If you’ve hit age 40, you should be checking these personal health numbers regularly. How often you should check will depend on your goals, your current health and your risks in and across categories.Blood Pressure – Most people check their blood pressure at their doctor’s office once a year and let it go at that. But if you’ve hit 40, you’ll want to get a home blood pressure monitor and check more frequently, particularly if any of the following apply to you:

  • You have a family history of heart disease
  • You have been diagnosed with prehypertension or hypertension
  • You have other cardiovascular risk conditions (high blood sugar level, excess body fat around the waist, abnormal cholesterol levels, high triglycerides)
  • You want to track and quantify how stress, diet and exercise impact your heart health

Today’s technology allows you to easily monitor BP and track trends over time. A combination of smart watch and health apps like Hello Heart (iOS, Android) keeps constant tabs on your blood pressure. Your data is recorded, analyzed and visualized for easy understanding by you and your physician.

Resting Heart Rate – This one is fairly simple. Before you tackle your day, take your resting heart rate. When you first wake up, take your pulse on your wrist or neck. If you are using a blood pressure monitoring device, this will probably be done for you by the device. You can then record and track your heart rate over time directly in Hello Heart.Cholesterol – According to the American Heart Association, if your numbers are good and your heart disease risk is low, cholesterol should be checked every four to six years. If your numbers are not good or you have any other heart health risk factors, your physician can help you determine how often your cholesterol should be reviewed on a more regular basis. A simple blood draw is all you need to endure to obtain these numbers. Then connect to your clinic online using Hello Heart and those numbers will automatically get transferred to the app along with clear explanations of what each number means.Blood Sugar – Blood sugar is typically measured by a blood test, after fasting for several hours. This should be done each year to monitor your overall health and detect early signs of diabetes. If you have already connected your clinic to Hello Heart, these new lab results will automatically import along with explanations of what each number means and what you can do about it.Home tests are available and used by those with diabetes for careful daily monitoring of blood sugar levels. These include blood tests from finger pricks, urine tests, and, most recently, sensor-based blood sugar readings that require no blood draws.C-Reactive Protein/Inflammation Number – Your CRP level is determined by a blood test. Yearly review of this number is healthy practice. It will help your doctor detect any problems associated with inflammation.Waist Size – Take out your tape measure several times each year to monitor this number. If you notice you are spreading the tape farther each time, you will need to make some lifestyle changes to reduce the risk of heart disease.Next Steps For Healthy Living Over 40When you turn forty, one option is to bottle your 40-phobia away and pretend like nothing has changed (If you’re a guy, you might buy a Porsche). An arguably more effective plan is to take stock in your future and take charge of your heart health. Consistent and frequent monitoring of these 6 health numbers will keep you on track for heart healthy living and plan for the long-run. Get a home blood pressure monitor. Download the free Hello Heart app (iOS, Android). Connect your clinic. Start tracking so you keep on top of your best game.

How High Blood Pressure Can Lead to a Heart Attack

The damage can build over time
The excess strain and resulting damage from high blood pressure (HBP or hypertension) causes the coronary arteries serving the heart to slowly become narrowed from a buildup of fat, cholesterol and other substances that together are called plaque. This slow process is known as atherosclerosis.

As arteries harden with plaque, blood clots become more likely to form. When an artery becomes blocked due to an accumulation of plaque or a blood clot, the flow of blood through the heart muscle is interrupted, starving the muscle of oxygen and nutrients. The damage or death of part of the heart muscle that occurs as a result is called a heart attack (myocardial infarction).

Watch what happens during a heart attack.

If you suspect you’re having a heart attack
Pain or pressure in the chest is the most common symptom of a heart attack. However, pain or discomfort in the arms, back, neck or jaw can also be a sign — and so can shortness of breath, nausea or light-headedness. If you experience one or more of these warning signs, CALL 9-1-1 immediately, even if you’re not sure it’s a heart attack. EMS staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. People with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.

Don’t let high blood pressure cause a heart attack

This content was last reviewed October 2016.

Is my blood pressure normal?

Answers to common questions about blood pressure

High blood pressure is one of the most common health conditions affecting the heart and blood vessels. This is why visiting your doctor to get your blood pressure checked is so important.

When it comes to your blood pressure, what you don’t know can harm your health. High blood pressure rarely has any noticeable symptoms. So often people don’t realise they have high blood pressure. What’s more, many of us are not aware of how the things we do in our daily lives can contribute to raising our blood pressure.

During Heart Week 2017 we are talking about the importance of knowing and managing your blood pressure.

What is blood pressure?

Your heart is a muscle that pumps blood into your body’s organs and tissues. Blood is pumped out of the left side of your heart into the arteries – the blood vessels that carry the blood’s oxygen and nutrients to your body. As the blood pumps out of the heart and into the arteries, it pushes against the artery walls. Blood pressure is the measurement of the pressure of the blood in the artery.

Blood pressure peaks when the heart muscle contracts and pumps blood, a cycle called systole. It falls when the heart relaxes and refills with blood, a cycle called diastole. Systole is the top number and diastole is the bottom number. It is displayed as two numbers, e.g 120/80 mmHg.

What is normal blood pressure?

An optimal blood pressure level is a reading under 120/80 mmHg. Readings over 120/80mmHg and up to 139/89mmHg are in the normal to high range. Your doctor will advise what your ideal blood pressure should be based on your circumstances.

What is high blood pressure?

Blood pressure over 140/90mmHg is generally considered to be high. When your blood pressure is high your heart and arteries can become overloaded. High blood pressure can accelerate the build-up of plaque on the artery walls (atherosclerosis), clogging blood flow to your heart muscle, putting you at risk of heart attack. It also weakens the walls of arteries in your brain which can cause stroke. It can affect arteries to other parts of your body too, such as the eyes, kidneys and legs. Long term high blood pressure is known as hypertension and is one of the main risk factors for heart disease.

What causes high blood pressure?

Blood pressure goes up and down throughout the day. It depends on the time of day, the amount of fluid in your body, the medicines in your system and what you are doing. Your blood pressure can also be affected by things like your breathing, your emotions, exercise and sleep. These temporary rises are completely natural and your blood pressure will generally return to normal when you rest.

The exact cause of high blood pressure is often not clear. However, various lifestyle conditions and behaviours have been known to significantly contribute to high blood pressure:

  • Being overweight
  • Not getting enough physical activity
  • Drinking more than 2 alcoholic drinks per day
  • Stress
  • Old age
  • Smoking
  • Family history of high blood pressure

Prolonged high blood pressure is known as hypertension. Left undiagnosed, hypertension can lead to several health issues, coronary heart disease (CHD) among them.

How to control high blood pressure

The good news is you can control (and even help prevent) high blood pressure by making healthy lifestyle choices. These include:

  • Following a healthy diet; reducing salt and fat intake and eating plenty of fruit and vegetables
  • Regular physical activity
  • Maintaining a healthy weight
  • Limiting your alcohol intake
  • Stopping smoking

Sometimes changes in your lifestyle alone may not be enough. Many people will also need medication to help reduce their blood pressure. If you need to take medication to lower your blood pressure your doctor will discuss this with you

How do I know if my blood pressure is healthy?

You should ask your doctor to check your blood pressure regularly. It’s easy and quick to do.

If you haven’t had your blood pressure checked lately – make an appointment to get it checked.

For more information on important lifestyle changes you can make to reduce your blood pressure levels please visit our keep your heart healthy page.

If you haven’t had your blood pressure checked lately – make an appointment to get it checked. Download and print our handy blood pressure recording card, and keep it with you to keep track of your numbers.

What Are the Odds of Having a Second Heart Attack?


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A heart attack, or myocardial infarction, occurs when the flow of oxygen to the heart stops suddenly. This is usually due to the build-up of fat and cholesterol in the arteries. Each year in the United States, about 735,000 people experience a heart attack. For 30% of them, it isn’t the first time. Once you have one heart attack, the risk for having another heart attack rises; this risk is especially high for 3 to 5 years after the first heart attack. Every heart attack is different, though, and you aren’t just a number. There’s a lot you and your doctor can do to help prevent a second heart attack.

You’ll probably have a lot of questions after a heart attack. Watch this video to learn more about the recovery process.

Medical Reviewers: William C. Lloyd III Last Review Date: 2018 Jan 31

2019 Healthgrades Operating Company, Inc. The content on Healthgrades does not provide medical advice. Always consult a medical provider for diagnosis and treatment. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

Transcript open 5 Things You Didn’t Know About Heart Attack Recovery 1. Most people survive their first heart attack.More than 90% of heart attack victims who make it to the hospital will make it out and be on the road to recovery. 2. Most heart attack patients return to work within two weeks to three months.The timeline will depend on the severity of the heart attack, as well as the physical and mental activity required of the job. 3. Depression can be a normal part of the heart attack recovery.Heart attack patients can experience a wide range of emotions after their first heart attack, including depression, fear and anger. Don’t be afraid to reach out for help and support. 4. Some chest pain is common.It’s possible to feel light pain or pressure in your chest after activity, an emotional moment or a heavy meal. It’s important to tell your doctor about any chest pain. 5. The right doctor can mean a world of difference.Finding the best doctor to help you with your heart attack recovery can increase your quality of life. Turn to Healthgrades.com to search for the right doctor for you. Share this video to help educate others about heart attack recovery!

Manage your heart attack risk factors.

About 86% of people who have a heart attack survive it, but certain lifestyle habits and medical conditions increase the risk of second heart attack, including:

  • Smoking, the most preventable risk factor

  • High blood pressure (hypertension)

  • High cholesterol

  • Lack of physical activity

  • Obesity

  • Drinking alcohol excessively

  • Diabetes

Work with your healthcare team to make improvements to your lifestyle habits where needed and maintain good control of other medical conditions. Adopting a heart-healthy diet low in saturated and trans fats is often an important first step in lowering bad cholesterol. Regular exercise can also help lower cholesterol, lower high blood pressure, and help you maintain a healthy weight.

Take your medications as prescribed.

It may not be possible to decrease your risk factors with lifestyle changes alone. Most heart attack survivors are prescribed some form of medication to help decrease their chances of second heart attack. It’s not unusual to go from taking zero medications before a heart attack to taking six or more afterward. Common medications include:

  • Baby aspirin taken once a day

  • Cholesterol-lowering medication

  • Medication to lower blood pressure

  • Anticoagulant medication that helps prevent blood from clotting if you have a stent

Your new medication routine will come with a learning curve, but it’s critical to stick with it. The American Heart Association offers these helpful tips:

  • Organize a list of your medications with dosage information into one chart.

  • Keep a weekly pill box up to date.

  • Schedule reminders on your smart phone.

  • If the cost of medication is a concern, let your doctor know. Alternative medications or prescription savings programs may be available.

Commit to cardiac rehabilitation if it’s recommended.

Doctors often recommend cardiac rehabilitation after a heart attack. If it isn’t offered to you, ask if it’s available. The foundation of cardiac rehabilitation is a personalized exercise prescription developed by a physiologist and overseen by a cardiologist, with medical monitoring that decreases as your heart health improves. There are usually four phases:

  • Phase 1: Walking as soon as possible after heart attack, often within 24 hours

  • Phase 2: Regular, monitored exercise sessions that use treadmills or exercise bikes and build up duration and intensity

  • Phase 3: Exercise sessions with less monitoring

  • Phase 4: Independent exercise without supervision

Surround yourself with support.

Just as every heart attack is different, and every person is different, the range of emotions you may feel after a heart attack can be different from someone else’s. Some people are scared. Others take it in stride. Some are angry or anxious about the future. Emotional support isn’t just nice to have. It’s been shown to help physical healing. Look to friends and family to hear you out and help you stay on the right track with your medications and lifestyle changes. Community and religious organizations can also help, especially if they include members who are in your same situation and can empathize. Check out online heart attack support groups, too.

About 20% of people experience depression after a heart attack and may need the assistance of a professional therapist. Let your doctor know if you think you might be depressed. Unlike feelings of sadness or loneliness that come and go, depression is characterized by persistent feelings of sadness and hopelessness and a loss of interest in activities you once enjoyed.

Managing your risk factors, taking new medications, developing new diet and exercise regimes, and participating in support programs may seem like a full-time job. All of it will get easier over time until it becomes second nature to put your heart health first. Avoiding another heart attack is a reward that’s well worth it.

How much do you really know about your heart’s health? It’s easy to be fooled by misconceptions. After all, heart disease only happens to your elderly neighbor or to your fried food-loving uncle, right? Or do you know the real truth – that heart disease can affect people of any age, even those who eat right?

Relying on false assumptions can be dangerous to your heart. Cardiovascular disease kills more Americans each year than any other disease. But you can boost your heart smarts by separating fact from fiction. Let’s set the record straight on some common myths.

  1. “I’m too young to worry about heart disease.” How you live now affects your risk for cardiovascular diseases later in life. As early as childhood and adolescence, plaque can start accumulating in the arteries and later lead to clogged arteries. One in three Americans has cardiovascular disease, but not all of them are senior citizens. Even young and middle-aged people can develop heart problems – especially now that obesity, type 2 diabetes and other risk factors are becoming more common at a younger age.
  2. “I’d know if I had high blood pressure because there would be warning signs.” High blood pressure is called the “silent killer” because you don’t usually know you have it. You may never experience symptoms, so don’t wait for your body to alert you that there’s a problem. The way to know if you have high blood pressure is to check your numbers with a simple blood pressure test. Early treatment of high blood pressure is critical because, if left untreated, it can cause heart attack, stroke, kidney damage and other serious health problems. Learn how high blood pressure is diagnosed.
  3. “I’ll know when I’m having a heart attack because I’ll have chest pain.” Not necessarily. Although it’s common to have chest pain or discomfort, a heart attack may cause subtle symptoms. These include shortness of breath, nausea, feeling lightheaded, and pain or discomfort in one or both arms, the jaw, neck or back. Even if you’re not sure it’s a heart attack, call 911 immediately. Learn you risk of heart attack today!
  4. “Diabetes won’t threaten my heart as long as I take my medication.” Treating diabetes can help reduce your risk for or delay the development of cardiovascular diseases. But even when blood sugar levels are under control, you’re still at increased risk for heart disease and stroke. That’s because the risk factors that contribute to diabetes onset also make you more likely to develop cardiovascular disease. These overlapping risk factors include high blood pressure, overweight and obesity, physical inactivity and smoking.
  5. “Heart disease runs in my family, so there’s nothing I can do to prevent it.” Although people with a family history of heart disease are at higher risk, you can take steps to dramatically reduce your risk. Create an action plan to keep your heart healthy by tackling these to-dos: get active; control cholesterol; eat better; manage blood pressure; maintain a healthy weight; control blood sugar; and stop smoking.
  6. “I don’t need to have my cholesterol checked until I’m middle-aged.” The American Heart Association recommends you start getting your cholesterol checked every 5 years starting at age 20. It’s a good idea to start having a cholesterol test even earlier if your family has a history of heart disease. Children in these families can have high cholesterol levels, putting them at increased risk for developing heart disease as adults. You can help yourself and your family by eating a healthy diet and exercising regularly.
  7. “Heart failure means the heart stops beating.” The heart suddenly stops beating during cardiac arrest, not heart failure. With heart failure, the heart keeps working, but it doesn’t pump blood as well as it should. It can cause shortness of breath, swelling in the feet and ankles or persistent coughing and wheezing. During cardiac arrest, a person loses consciousness and stops normal breathing.
  8. “This pain in my legs must be a sign of aging. I’m sure it has nothing to do with my heart.” Leg pain felt in the muscles could be a sign of a condition called peripheral artery disease. PAD results from blocked arteries in the legs caused by plaque buildup. The risk for heart attack or stroke increases for people with PAD.
  9. “My heart is beating really fast. I must be having a heart attack.” Some variation in your heart rate is normal. Your heart rate speeds up during exercise or when you get excited, and slows down when you’re sleeping. Most of the time, a change in your heartbeat is nothing to worry about. But sometimes, it can be a sign of arrhythmia, an abnormal or irregular heartbeat. Most arrhythmias are harmless, but some can last long enough to impact how well the heart works and require treatment.
  10. “I should avoid exercise after having a heart attack.” No! As soon as possible, get moving with a plan approved for you! Research shows that heart attack survivors who are regularly physically active and make other heart-healthy changes live longer than those who don’t. People with chronic conditions typically find that moderate-intensity activity is safe and beneficial. The American Heart Association recommends at least two and a half hours of moderate intensity physical activity each week For Overall Cardiovascular Health. Find the help you need by joining a cardiac rehabilitation program, but first consult your healthcare provider for advice on developing a physical activity plan tailored to your needs.

Non-smoker, with normal blood pressure and cholesterol levels has heart disease. Why?

Inflammatory reactions increase plaque instability, possibly resulting in plaque rupture or erosion

Our understanding of the biology of atherosclerosis has always incorporated the so-called inflammatory hypothesis. Inflammatory cells and signals drive the healing response to vascular injury, allowing the initiation and growth of atherosclerotic plaque. Inflammatory reactions increase plaque instability, possibly resulting in plaque rupture or erosion and setting up the response that causes myocardial damage and heart attack.

In a bullish presentation at the ESC, principal investigator Dr Paul M Ridker, director of the Centre for Cardiovascular Disease Prevention at Brigham and Women’s Hospital in Boston, said : “For the first time, we’ve been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk. This has far-reaching implications. By leveraging an entirely new way to treat patients – targeting inflammation – we may be able to significantly improve outcomes for certain very high risk populations.”

“In my lifetime, I’ve seen three broad eras of preventative cardiology. First we recognised the importance of diet, exercise and smoking cessation. Then we saw the tremendous value of lipid-lowering drugs such as statins. Now we’re cracking the door open on the third era. This is very exciting,” he told delegates.

It’s a case of welcome back inflammation to the heart disease frontline

However, a more measured editorial in the New England Journal of Medicine noted: “Cantos has helped move the inflammatory hypothesis of coronary artery disease forward scientifically. However, the modest absolute clinical benefit of canakinumab cannot justify its routine use in patients with previous myocardial infarction until we understand more about the efficacy and safety trade-offs and unless a price restructuring and formal cost-effectiveness evaluation supports it.”

It’s a case of welcome back inflammation to the heart disease frontline but let’s wait for a suitable drug.

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