Your Heart Doesn’t Have to Wear Out: Aging and Heart Health Redefined - Part 1
- Dr. Sharafsaleh
- Sep 28
- 5 min read
For decades, doctors and patients alike believed the heart was like a car engine, built to run for a certain number of miles before it inevitably “wore out.” However, modern science has turned that idea on its head. Your heart isn’t doomed to fail with age. In fact, with the proper care and habits, it can stay strong and healthy well into later life.
As a geriatrician and lifestyle medicine physician, I see every day that the heart responds powerfully to our actions, specifically, how we eat, move, sleep, connect, and manage stress. When we combine the six pillars of Lifestyle Medicine with a geriatric approach to care, we get a roadmap for heart health that’s both preventive and personalized.
How Our Understanding of the Aging Heart Has Changed
Old belief: Aging meant the heart muscle wore thin and eventually failed.
New reality: While arteries and heart muscle do change with age, most decline we once accepted as “normal” is actually driven by lifestyle — inactivity, poor nutrition, smoking, chronic stress, and uncontrolled blood pressure or cholesterol.
Good news: Across the lifespan, healthy choices can reduce heart disease risk, improve fitness, and even promote beneficial changes in the heart muscle, showing that it’s never too late, or too early, to support your heart.
The Six Pillars of Lifestyle Medicine for Heart Health
Whole-food, plant-forward nutrition
Vegetables, fruits, whole grains, legumes, nuts, and seeds lower inflammation and keep arteries flexible.
Physical activity
Regular physical activity strengthens the heart, lowers blood pressure, improves insulin sensitivity, and helps protect against weight gain. (In Part 2, we’ll explore exactly how much and how hard to exercise.)
Restorative sleep
Seven to nine hours of quality sleep supports healthy blood pressure and lower stress hormones.
Stress management
Chronic stress keeps adrenaline and cortisol elevated, driving hypertension and inflammation. Mindfulness, breathing exercises, or gratitude practices can help.
Avoidance of risky substances
No tobacco, minimal alcohol — both harm blood vessels and raise blood pressure.
Social connection
Loneliness increases heart disease risk. Staying connected to friends, family, and purpose adds healthy years to life.
Adding the Geriatric 5Ms — A Unique Lens on Heart Health
Lifestyle medicine gives us the “what.” Geriatrics helps us personalize the “how”:
Mind – Monitor memory and mood; depression and cognitive decline can affect heart care and motivation.
Mobility – Good balance and strength reduce the risk of falls and keep people active enough to engage in heart-protective exercise.
Medications – Reviewing prescriptions avoids harmful interactions and over-treatment.
Multi-complexity – Tailor plans for those with diabetes, kidney disease, arthritis, or other chronic issues.
Matters Most – Align prevention with what matters most: independence, family time, and meaningful living, not just lab numbers.
Combining these two approaches turns heart prevention into personalized, whole-person care. Learn more about how Geriatrics and Lifestyle Medicine work together on the GeriAcademy blog, The Perfect Pair: How Geriatrics and Lifestyle Medicine Work Together.
Practical Steps I Recommend to Support a Healthy Heart as You Age
Know your numbers
Ask your healthcare provider to monitor your blood pressure, cholesterol (including ApoB and LDL particle size, which you can learn more about on the GeriAcademy blog, "Cholesterol: It's More Than Just a Number"), and blood sugar levels regularly.
Example: If your blood pressure is creeping up (e.g., 128/82), start with lifestyle steps, such as reducing sodium intake, increasing daily physical activity, and managing stress, before considering medication.
Move most days — and mix it up.
Walking briskly, cycling, swimming, dancing, or taking group fitness classes all count. Even short bouts add up.
Example: Ten minutes after each meal can improve blood sugar and blood pressure. If you can, add strength training twice a week (resistance bands, bodyweight exercises, or light weights).
Eat colorfully and mostly plants.
Aim for a variety of vegetables and fruits at each meal. Replace white bread with whole grain, swap red meat for beans, lentils, or fish, and cook with olive oil instead of butter.
Example: A lunch of mixed greens, chickpeas, colorful veggies, and olive oil dressing supports vascular health and keeps you full.
Prioritize sleep and manage stress.
Stick to a consistent bedtime, reduce screen time before bed, and try breathing exercises or guided meditation.
Example: Just 5 minutes of slow breathing or gratitude journaling before bed can lower heart rate and stress hormones.
Schedule medication reviews
Especially important if you take several prescriptions. Some medications can raise blood pressure or interact with heart medicines.
Example: Bring your complete list — including over-the-counter medications and supplements to each visit and ask if any of them might affect your heart health.
Stay socially connected
Regular connection protects heart health.
Examples: Join a book club, volunteer, take a fitness class with friends, or call a family member on a daily basis. Social engagement helps lower stress and improve adherence to healthy routines.
Work with your care team.
Trainers, physical therapists, or exercise physiologists can safely adapt workouts for individuals with arthritis, balance issues, or chronic conditions.
Example: If you’ve had joint replacements, a trainer can modify moves to keep your heart strong without risking injury.
Watch for warning signs.
New shortness of breath, chest pressure, swelling in your legs, or unusual fatigue warrant prompt medical evaluation.
Example: Don’t ignore a “can’t catch my breath” moment on the stairs; it could be your heart asking for help.
The Takeaway
Your heart isn’t destined to “poop out.” Aging does bring changes, but you have tremendous control over how your heart ages. By combining evidence-based lifestyle habits with a personalized geriatric perspective, you can maintain your health and protect your heart for years to come.
Coming next: In Part 2, we’ll talk about exactly how much — and how hard you should exercise, why “150 minutes a week” matters, and how to train in the right heart-rate zones for longevity.
References
Murray A, Brown JC, et al. Aging, aerobic exercise, and cardiovascular health: Barriers, alternative strategies and future directions. 2023. PMC10068966
Perry AC, Levine BD, et al. Physical Activity Over the Lifecourse and Cardiovascular Disease. Circ Res. 2023. AHA Journals
Vigorito C, Giallauria F. Effects of exercise on cardiovascular performance in the elderly. Front Physiol. 2014. PMC3929838
American College of Lifestyle Medicine. Six Pillars of Lifestyle Medicine. 2023.
Tinetti ME, Huang A, et al. The 5Ms Framework in Geriatric Care. J Am Geriatr Soc. 2017.
This article is for general informational purposes only and is not a substitute for personalized medical advice. Everyone’s health is unique; please talk with your physician or healthcare provider before making changes to your exercise routine, diet, or medications.
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