Finding The Heart Healthy ‘Sweet Spots’ As You Age


Heart disease is the leading cause of death for all people; and three out of every four men and women age 60+ have at least one major disease that is related to heart health— a history of smoking, diabetes, high blood pressure, or high cholesterol. But the good news is that in most cases, heart disease can be prevented. While you can’t stop aging, if you have any of these risk factors it’s never too late to boost your heart health by focusing on what we like to call the “sweet spots.”

Cigarette Smoking: Smoking makes your heart work harder, raises blood pressure, and increases your risk of dying from heart disease, heart failure, or a heart attack. Smoking cigarettes can shave 10 years off your life, but your risk of dying or having a heart attack drops by 50 percent after quitting for one year, and drops more as time goes on if you do not start smoking again.

Sweet Spot: Quitting smoking (without switching to vaping) is the best way to reduce the risks that come with smoking. There are many options to help people quit smoking, including hypnotherapy, acupuncture, behavioral counseling, and a prescription nicotine inhalation system that gradually reduces the urge to smoke.

Diabetes (Type 2): High levels of blood sugar from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. To lower the sugar level in your blood, most people’s diabetes responds well to lifestyle changes, such as eating a healthy diet, getting regular exercise and losing weight.

Sweet Spot: I ask my patients in their 60s or 70s how much they weighed when they were in good shape, in their 20s or 30s. That helps us to develop diet and exercise goals to either stop the development of full-fledged diabetes if they are in the pre-diabetes stage, and may even reverse early-stage diabetes. Losing just 5-10 percent of body weight can often reduce the risk of diabetes and heart disease.

High Blood Pressure: High blood pressure is quite common, often has no symptoms, yet can lead to stroke and sometimes death. The ideal blood

pressure is less than 120/80, which is easy to monitor at home with a blood pressure cuff that can be purchased at a drug store. The goal is to gradually lower blood pressure, since a drastic or quick reduction may cause dizziness, weakness or fainting.

Sweet Spot: Too much salt in the diet is one common cause of high blood pressure. Limiting salt to no more than half a teaspoon per day can help lower the pressure, as can the use of medication that is gradually adjusted over weeks to months.

High LDL Cholesterol: High LDL (bad cholesterol) can damage your arteries over time and increase the risk for heart disease, heart attack and stroke. Cholesterol levels tend to climb as we age, but individuals in their 70s and even 80s benefit from low LDL.

Sweet Spot: High fiber foods such as oats and beans can lower LDL, as can safe and effective cholesterol-lowering medications, which have been proven to reduce the risk of a heart attack and stroke.

These heart healthy “sweet” spots are just a starting point. Heart disease prevention and treatment as you age is really a partnership between you and your doctor, with regular checkups to see how you’re doing, changes to medications or exercise routine as needed, and coaching on how to take better control of risk factors.

Michael Miller, MD, is a Professor of Medicine, Epidemiology & Public Health at the University of Maryland School of Medicine and Director, Center for Preventive Cardiology, University of Maryland Medical Center. He is author of the book, “Heal Your Heart: The Positive Emotions Prescription to Prevent and Reverse Heart Disease.” Learn more at