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Like your hair and skin, your cardiovascular system also changes as you age. Starting as early as age 20, your heart and blood vessels start to gradually change over time, even in healthy cardiovascular systems. This can include a change in heart rate or rhythm, changes to the shape of the heart, thickening of heart valves and blood vessels, and more.

In a healthy cardiovascular system, the right side of the heart pumps blood to the lungs to receive oxygen and get rid of carbon dioxide, while the left side pumps oxygen-rich blood to the body.

Your arteries flow out of the heart, branching out and getting smaller as they go into your tissues until they become tiny capillaries. Capillaries provide oxygen and nutrients to the tissues, and receive carbon dioxide back from them. That carbon dioxide is then carried into larger and larger veins, which return blood to the heart.

However, your risk of heart problems start to slowly increase as you get older due to normal, age-related changes to your cardiovascular system, such as:

  • A slightly slower heart rate due to fibrous tissue and fat deposits that develop in the body’s natural pacemaker system that controls the heartbeat. The natural pacemaker (the SA node) also loses some of its cells.
  • The heart fills more slowly due to thickening of the heart wall, which can cause the heart chamber to hold less blood.
  • Stiffening and thickening of heart valves, which control the direction of blood flow, and the heart wall. This can decrease the heart’s tolerance for exercise and other stressors.
  • Slight thickening of capillary walls, which may cause a slightly slower rate of exchange of nutrients and waste.
  • Less flexibility, stiffness, and thickening of the aorta, which can cause blood pressure to rise and make the heart work harder.
  • Decrease in the production of certain white blood cells called neutrophils, which are important to immunity. This can reduce your ability to resist infection.
  • Slower production of red blood cells during stress or illness, which creates a slower response to blood loss and anemia.


Age is a predominant risk factor when it comes to risk of heart failure. In fact in the United States, 50% of all heart failure diagnoses and 90% of all heart failure deaths occur in those aged 70 and above. Researchers credit these numbers with a “convergence of declining cardioprotective systems and increasing disease processes.”

What this means is that while cardiovascular changes are a normal part of aging, when combined with risk factors for heart disease that are modifiable, they can increase your risk of heart failure. For example, high blood pressure, cholesterol levels, diabetes, obesity, and smoking are all risk factors for heart disease that you can address to help lower your risk.

You can keep your level of risk low by:

  • Eating a heart-healthy diet with reduced amounts of saturated fat and cholesterol.
  • Exercise regularly to control your weight, manage blood sugar, and reduce stress.
  • Reduce or stop smoking.
  • Have regular check-ups for your heart to monitor your blood pressure and cholesterol.
  • Follow your health care practitioner’s recommendations for treating high blood pressure, high cholesterol, or diabetes.

Plus, an older heart may not be able to pump blood as well when you make it work harder, so it’s important to be aware of certain medications, emotional stress, illness, infections, injuries, and physical exertion that can all make your heart work hard.


It’s important to speak to your health care practitioner regarding shortness of breath, fatigue, chest pain, or any other concerning symptoms. To determine the health of your heart, your doctor may perform a physical exam or order lab tests and imaging to investigate the cause for symptoms.

Imaging could include a heart ultrasound, called an echocardiogram, to examine the structure and function of the heart. Or, to find out how your heart performs under stress, your doctor might order an exercise stress test or myocardial perfusion imaging (MPI).

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Heart and Stroke Foundation (2019) “Heart/Emergency Signs.” Accessed May 23, 2019.

Strait, J.B., & Lakatta, E.G. (2012) “Aging-associated cardiovascular changes and their relationship to heart failure.” Heart Failure Clinics. Jan. 8(1): 143-64. Accessed May 23, 2019.

U.S. National Library of Medicine (2019) “Aging changes in the heart and blood vessels.” Medical Encyclopedia. Accessed May 17, 2019.

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