Written by: Ibani Kapur
Medically reviewed by: Rob Philibert MD PhD
The body undergoes macro- and microscopic changes throughout its lifetime starting at birth and lasting until death in a process referred to as aging. But what exactly is aging? To systems biologists, it is the process of progressive decline of the efficiency of molecular and cellular processes in the body. Over time, accumulation of these molecular changes negatively impacts the structure and function of all the organs of the body including the heart. Therefore, not surprisingly, one of the largest risk factors for cardiovascular disease is aging.
The effect of aging on cardiovascular health is profound. Structural changes in the heart are evident from stiffening of arteries that leads to increased resistance to blood flow that manifests clinically as hypertension. To compensate for this arterial stiffness, muscle mass of the heart increases, causing what is known as hypertrophy. However, this enlargement of muscle mass in turn results in increased demand for oxygen and blood flow. Addressing this escalating “arms race” is essential to efforts to mitigate the effects of aging.
Although the changes associated with aging are progressive and begin at birth, the onset of clinical symptoms of aging typically occurs in middle to late adulthood. Gender also plays a role in the timing of onset. In particular, conditions such as hypertension (high blood pressure) and coronary heart disease show a sharp increase of frequency at the age of 45 for men while the onset for women is almost a decade later. Sex specific hormones may be responsible for these differences. In a recent study by Dr. Aayush Visaria of Rutgers University, 13,253 adults aged 20 and above were separated into age groups with a difference of 10 years of age, and their blood pressure ascertained. Their results showed that younger men and older women were more likely to have uncontrollable hypertension. While lifestyle choices and financial pressure in the middle age were suggested as possible causes for early blood pressure complications in men, the researchers noted that for women the risk of cardiovascular disease increases after menopause.
Although increasing age is the largest factor risk to cardiovascular health, it is largely an unavoidable one. In contrast, the influence of adverse health and lifestyle behaviors are potentially avoidable and should not be ignored. According to the American Heart Association (AHA) lifestyle management is essential in reducing cardiovascular risk in adults. Poor nutrition, sleep behavior, physical inactivity and smoking are all modifiable conditions that are linked to adverse outcomes cardiovascular (CVD). The likelihood of other conditions that increase risk for CVD like diabetes and obesity also increase with age. As a result, older diabetic patients frequently present to hospital with CVD related complications such as stroke, chest pain and restricted blood flow that reflect some of the shared risk factors and pathophysiology of the two disorders.
The good news is that unlike increasing age, both CHD and diabetes can be prevented. Basic prevention for both disorders are strikingly similar. Engage in regular exercise, eat a healthy, low fat diet and don’t smoke- don’t ever smoke. At the same time, it is also important to routinely monitor yourself for these conditions. For diabetes, clinicians rely on the hemoglobin A1c test, which measures the amount of sugar attached to the hemoglobin in your blood. For CHD, clinicians can use either older technologies such as lipid profiling or use recently developed epigenetic technologies, such as Epi+Gen CHD, to assess risk. Although either is better than nothing, Epi+Gen CHD is much more sensitive in detecting risk, particularly for women. But like exercise treadmills, tests only work if you use them! So, contact your local clinician or go on the web to providers such as the physicians at Elicity Health to get tested now!
In conclusion, while aging is a concern for all of us, there are additional modifiable risk factors that increase the risk of cardiovascular disease. Control your destiny. Exercise, eat well and get tested -now!