Age is a natural process, something that cannot be modified, so it doesn’t seem that age can be a risk factor. But it is true that as we grow older, we face many medical conditions that are particular to aging. One important risk is that of developing heart disease.
What is Heart Disease?
Heart disease is caused by the gradual buildup of plaques (or fatty deposits) in the walls of the coronary arteries over many years. This is called atherosclerosis in the medical language. Coronary arteries surgery that surrounds the outside of our heart, supply oxygen and blood nutrients to the heart muscle. And, when plaque builds up inside these arteries, they get constricted resulting in a blocked or reduced supply of oxygen and blood nutrients to the heart. And, reduced or blocked the flow of blood to the heart due to plaque buildup or if a plaque ruptures suddenly, it may cause chest discomfort or pain or a heart attack. When the heart does not get enough blood nutrients and oxygen, its cells will weaken the heart or die therefore, reducing its ability to pump blood to our entire body.
Does Heart Change with Age?
Yes! Aging can cause changes in the heart including the blood vessels. As you age, your heart cannot beat as fast as it used to when you were younger during any physical activity or stressful times. But, with normal aging, the heart rate (number of beats per minute) at rest does not change drastically. In addition, fatty deposits may buildup in the walls of arteries over many years which may become a major cause of heart disease.
The most common change owing to aging is the hardening of arteries or increased stiffness of arteriosclerosis, the large arteries. This may cause hypertension (high blood pressure), which gets more common as we grow older.
Is age a risk factor for heart disease?
With developments in modern medicine and new treatments for heart disease, while there is a decline in mortality, there is an increased prevalence of heart disease in line with the rise in NCDs (non-communicable diseases). When it comes to the risk of developing heart disease, around 75 to 90% of the risk comes from risk factors other than age. These include other non-modifiable factors like gender, ethnicity and family history, and modifiable lifestyle and diet factors that include decreased physical activity with more of sedentary office work, and an unhealthy diet with less fiber, vegetables, and fruits along with abuse of tobacco and alcohol. These contribute to high blood pressure, obesity, and diabetes which in turn are major risk factors for heart disease.
Various risk scores or risk screening tools allow a physician to evaluate an individual’s risk of developing heart disease. Some commonly used screening tools are the Framingham Risk Score and the Reynolds Risk Score. In India, Microsoft India and Apollo Hospitals launched the first ever AI-powered Cardiovascular Disease Risk Score API in August 2018. This has been designed specifically to predict the risk of heart disease in the Indian population.
Age and Other Risk Factors – The Correlation
The question before us is – Is age an independent risk factor with older age having a greater risk of heart disease? Is it the accumulation of various risk factors as we age in our life that has an effect on the increased risk of heart disease as we grow older? Will avoiding the other risk factors reduce the risk of heart disease associated with age per se?
The answer is not too complex. It is important to understand that the risk of developing heart disease does not have a linear correlation with age. The lifetime risk for developing heart disease is lower at age 80 than say, at age 50 years for an individual whose lifestyle risk factors remain the same. The reasons for this may include a shorter time period left to develop the disease as one grows older, a lower burden of cardiovascular risk factors, or a genetic resistance to develop cardiovascular disease.
Age of an individual does have an effect on the evaluation of short term as well as long term risk of heart disease. It is easy to comprehend that if two individuals, one young and one old have the same other risk factors for heart disease like smoking, increased cholesterol levels, etc., the younger one will have a lower short-term risk of developing heart disease as compared to the older individual.
Studies have indicated that the absence of the traditional risk factors is associated with a reduction in the risk of heart disease even at an older age. At an older age, the contribution of age as a risk factor for heart disease reduces because there is less time for the other risk factors to come into play. The age-associated risk of heart disease can be minimized by modifying and/or avoiding the other risk factors. Hence, modifying the various risk factors is important irrespective of the age of the individual to reduce the risk of developing heart disease at a later stage.
It is also important to understand the role of age as a risk factor so that the patient can be given the proper advice about his or her risk depending on his or her age, and a realistic understanding of the impact of lifestyle change on treatment outcomes.
The Bottom Line
The conclusion is that screening for risk factors and advice about modifying and managing risk factors should start early and definitely be carried out regularly after the age of 40 years – at least until the time someone discovers the elixir of life to make us stay young forever!
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