40 Heart Risk Factors You Need to Pay Attention to After 40
Where you live and what you put in your coffee affects your most vital organ.
When you reach your 40s, your heart health becomes more of a concern than ever before. According to a 2015 report from the American Heart Association (AHA), approximately 6.3 percent of men and 5.6 percent of women between the ages of 40 and 59 battle coronary heart disease each year. And those rates nearly double as the decades go on.
To avoid becoming a statistic, the best thing you can do—in addition to being acutely aware of the common heart attack symptoms—is brush up on some heart risk factors that may be putting you in harm's way.
Not taking enough vacation time
It turns out, a weeklong getaway at the beach is just what the doctor ordered. In one 2000 study published in the journal Psychosomatic Medicine, researchers found that middle-aged men who took frequent vacations were less likely to die from coronary heart disease over a nine-year period compared to men who never took advantage of their PTO.
Similarly, the researchers documented that 24 percent of participants who vacationed infrequently suffered from a nonfatal cardiovascular event during the trial, compared to 19 percent of frequent vacationers.
Being magnesium deficient
If you're worried about your heart, then you should consider getting your magnesium levels checked. As one 2005 study published in the journal Clinical Calcium notes, "magnesium deficiencies are common and can be associated with risk factors and complications of heart failure."
The good news is that there's an easy fix for low magnesium levels. According to Natalie Collier, MScN, a clinical nutritionist with Wellnicity, you can add magnesium through supplements or through foods like legumes, whole grains, and fatty fish.
Eating a meat-heavy diet
It might be worth adopting a vegetarian diet once you make it to your fourth decade. When a team at the Cleveland Clinic compared the effects of red meat, white meat, and no meat at all on healthy individuals, they found that those eating red meat had triple the amount of trimethylamine N-oxide (TMAO), a dietary byproduct that contributes to heart disease.
Getting the flu
If you don't want to have a heart attack, then make sure you get your flu shot every year. One 2018 study published in the New England Journal of Medicine analyzed 360 patients hospitalized with heart attacks and found that they were six times more likely to end up in the hospital the week after being diagnosed with the flu compared to years they didn't have the contagious respiratory illness.
Having an excessive amount of wrinkles
Of course, most adults over the age of 40 have at least some wrinkles, but an excessive amount of deep forehead folds could be an indication of a less-than-healthy heart, according to a study presented at the European Society of Cardiology Congress in 2018. The researchers followed 3,200 adults for 20 years, during which time 233 subjects died. Of these, 22 percent had forehead wrinkles and 2 percent had no wrinkles.
Undergoing breast cancer treatment
Of all the women in the United States diagnosed with breast cancer every year, fewer than 5 percent are under the age of 40, according to The Susan G. Komen Breast Cancer Foundation. And unfortunately, a 2013 study published in the New England Journal of Medicine found that rates of coronary events increased by 7.4 percent for every gray of radiation (a unit used to measure the total absorbed energy of radiation) delivered during breast cancer treatment.
Living at a low altitude
You might want to think twice before buying a home in a low-altitude city like Washington D.C. When Spanish researchers followed 6,860 undergraduates over a 10-year period, they found that those living at the highest altitudes had a much lower risk of developing metabolic syndrome—a collection of risk factors associated with heart disease and stroke—compared to those residing at low altitudes.
According to a 2019 study published in the journal Diabetes Care, atherosclerotic cardiovascular disease—a buildup of plaque inside the heart's arteries—is the leading cause of death among individuals with diabetes.
However, having diabetes doesn't automatically mean that you are going to die of a heart problem. The same study notes that when other risk factors—like obesity, hypertension, and smoking—are kept in check, diabetes patients are much more able to manage their heart health.
Psoriasis causes inflammation on both your skin and inside your body, according to the American Academy of Dermatology. If this inflammation goes untreated for a long period of time, it "may affect your heart and blood vessels, putting you at greater risk of developing heart disease."
In fact, per one 2005 study published in the Journal of Dermatological Treatment, the prevalence of heart disease among people with psoriasis is 14 percent compared to 11 percent for the general U.S. population.
Living in a noisy area
If you've spent most of your years living in a city, you may find yourself paying the price in your 40s and 50s. A 2015 study published in the European Heart Journal found that long-term exposure to noisy traffic is associated with a slightly elevated risk of cardiovascular death, particularly when it comes to strokes.
Developing late-onset asthma
As the Asthma and Allergy Foundation of America notes, "asthma symptoms can occur at any time in life." But what does it have to do with your heart? Well, a 2016 study published in the Journal of the American Heart Association followed participants for about 14 years and found that those with late-onset asthma had a higher risk of cardiovascular disease.
PPIs, or proton-pump inhibitors, are drugs prescribed for heartburn and acid reflux. Though effective, a 2015 study from Stanford University found that these medications can increase a person's chance of having a heart attack, especially if they've had one in the past. The researchers hypothesize that the drugs deplete nitric oxide levels, which the blood vessels need for proper blood flow and blood pressure regulation.
Suffering from migraines
Migraine sufferers should pay extra attention to their tickers. Per one 2009 study published in the journal Neurology, suffering from migraines—especially with aura (meaning flashes of light, blind spots, and other vision issues)—is a risk factor for ischemic lesions of the brain, angina, stroke, and heart attack.
Eating dinner right before bed
Though it is the cultural norm to eat dinner late at night in some European and South American countries, doing so may have serious consequences. When Brazilian researchers analyzed data on heart attack patients in 2019, they found that those who tended to eat later were four to five times more likely to die as a result of the cardiac event, or to suffer from another heart attack within a month of being discharged from the hospital.
Speaking of mealtimes, skipping breakfast is just as bad for your heart as eating dinner late at night. In the same 2019 study, researchers found that heart attack sufferers who regularly missed their morning meal were also four to five times more likely to die from the event or to have another heart attack within a month of leaving the hospital.
Using antibiotics for an extended period of time
Taking a week's worth of antibiotics for strep throat isn't a major heart risk factor in the long run. But you might want to be a bit wary if you've ever taken antibiotics for months at a time.
In one 2019 study published in the European Heart Journal, researchers found that women between the ages of 40 and 59 who took antibiotics for at least two months had an increased risk of heart problems. According to the scientists behind the study, taking antibiotics in excess can destroy the "good" bacteria in the gut, allowing for viruses and other bacteria to enter.
If you're feeling depressed or anxious, then you should seek out professional help—not just for the sake of your mental health, but for your heart health as well. In one 2018 study published in the journal Circulation: Cardiovascular Quality and Outcomes, scientists found that adults over the age of 45 dealing with mental health issues like depression and anxiety had an increased risk of cardiovascular disease. Specifically, women with high psychological distress had a 44 percent increased risk of stroke and men with high psychological distress had a 30 percent increased risk of heart attack compared to those without mental health issues.
Or being stressed
According to Dr. Robert Greenfield, a cardiologist, lipidologist, and medical director of Non-Invasive Cardiology & Cardiac Rehabilitation at MemorialCare Heart & Vascular Institute in California, chronic stress becomes an increasingly serious heart risk factor as you age. He explains that stress raises "both adrenaline and cortisone, which have detrimental effects on the heart and blood vessels by disrupting the smooth lining of the blood vessels, known as the endothelium." If you notice a pattern of stress or anxiety, finding a strategy to combat it—whether that's therapy, exercise, medication, or by other means—will benefit more than your emotional well-being.
Living in a polluted place
Not only can the smog in your city lead to respiratory problems, a 2014 study published in Toxicology Research also shows that both ambient air pollution and particulate matter are linked to cardiovascular disease.
According to Greenfield, "particulate matter that we breathe in everyday sets up a different kind of stress we call 'oxidative stress' and accelerates the atherosclerotic process. Residents of big cities with lots of traffic suffer the most." According to the World Health Organization, 43 percent of air pollution-related deaths are attributed to chronic obstructive pulmonary disease, and 25 percent are the result of ischemic heart disease—both far more likely to affect the over-40 population.
Having an inflammatory condition
Inflammation can occur for a lot of reasons, but it tends to happen more often as we reach middle age. As Greenfield points out, in many cases "it can be a part of arthritis, or just periodontal disease." But he warns that whatever the root cause, it's the impact that we should be aware of.
"Inflammation causes a chemical stress in the body that can accelerate atherosclerosis or cholesterol plaque buildup in our precious coronary arteries," he says. In some cases, patients even experience a condition called myocarditis: inflammation of the heart muscles themselves.
"Achieving a healthy weight is generally recommended as heart healthy, but maintaining weight loss is difficult and fluctuations in weight may make it harder to achieve ideal cardiovascular health," Brooke Aggarwal, Ed.D., M.S., assistant professor of medical sciences at Columbia University Vagelos College of Physicians and Surgeons, said in a statement.
When she and her team investigated 485 women with an average age of 37 years old, they found that those who had lost 10 pounds only to regain it within a year were 82 percent less likely to have an optimal body mass index. Seeing as BMI is directly correlated to heart risk factors, the study concluded that yo-yo dieting is less than beneficial for heart health.
Eating a high-sodium diet
"High blood pressure is often linked to sodium intake," says Collier. And, according to WebMD, hypertension is closely linked with hypertensive heart disease, which includes everything from left ventricular hypertrophy to total heart failure. According to the American Heart Association, you should aim to consume no more than 2,300 mg of sodium per day, though 1,500 mg is the true ideal amount.
If you're losing teeth in your 40s, you might want to visit the cardiologist in addition to your dentist. According to research presented at an American Heart Association event in 2018, middle-aged adults who lost two or more teeth showed an increased risk of cardiovascular disease. During the duration of the study, these participants had a 23 percent increased risk of heart problems compared to those who retained all their teeth.
Having gray hair
Before you dye your gray hairs, listen to what your natural locks are trying to tell you about your heart health. One study presented at the European Society of Cardiology's EuroPrevent 2017 examined 545 adult men and found that those with at least half a head of gray hair had an increased risk of coronary artery disease. According to the researchers, both atherosclerosis and the graying process "occur through similar biological pathways," which might explain why one is indicative of the other.
Using artificial sweeteners
If you think that using artificial sweeteners in place of real sugar is helping your health, think again. One 2017 meta-analysis published in the Canadian Medical Association Journal (CMAJ) concluded that there is a clear link between consuming artificial sweeteners and an increased risk of obesity, high blood pressure, heart disease, and diabetes. You may be better off just sticking with the real stuff! And for more helpful health facts, don't miss these 20 Habits That Slash Your Flu Risk.
The risk of heart disease increases for both men and women as they age, but the American Heart Association explains that certain risk factors and symptoms of cardiovascular disease spike at the onset of menopause in women. For many women, peri-menopause can begin just after 40, when estrogen levels (known to have a positive effect on keeping artery walls flexible) begin fluctuating, so be sure to talk to your doctor about any heart health concerns if you think you might be entering—or close to entering—menopause.
Undergoing hormone replacement therapy
While some clotting in the blood is normal (and important!), excessive blood clotting known as hypercoagulation is a serious concern when it comes to heart health. And women that take hormone replacement drugs during or after menopause are at an increased risk for blood clots, which can lead to pulmonary embolism, peripheral artery disease, stroke, and heart attack—all potentially life-threatening concerns. According to the American Heart Association, women can mitigate the threat by maintaining a healthy weight, staying hydrated, wearing compression garments, and recognizing the symptoms of a clot. They can also speak with their doctor about alternatives to estrogen-based medication.
A 2018 study published in Baylor University Medical Center Proceedings details the case of a 41-year old bodybuilder with an extensive history of abusing anabolic androgenic steroids (AAS). The unfortunate result was multi-system organ failure and severe cardiac effects for the patient, who previously had no medical, surgical, or family history to suggest an alternate cause.
As the study concluded, "emerging consensus supports an association of AAS abuse with an increased risk of sudden cardiac death, myocardial infarction, abnormal lipid profile, and cardiac hypertrophy." The good news? After quitting steroid use during his seven-day hospitalization, the patient's arrhythmia stabilized, and his ventricular function had already improved.
Though e-cigarettes are often touted as a healthier alternative to traditional cigarettes, research is emerging that counters these claims. For instance, one 2018 study published in the American Journal of Preventive Medicine found that using e-cigarettes on a daily basis can nearly double a person's heart attack risk.
Having high cholesterol.
According to the Centers for Disease Control and Prevention (CDC), in 2015, more than 12 percent of adults ages 20 and older had total cholesterol higher than 240 mg/dL when it should be somewhere below 200 mg/dL. And this is especially bad for folks over the age of 40, seeing as one 2015 study published in the journal Circulation found that even slightly elevated cholesterol levels can impact an otherwise healthy individual's heart health in the long term. According to the study, every decade that a person lives with high cholesterol is linked to a 39 percent increased risk of heart disease.
Insomnia is just as bad for your heart as it is disruptive to your schedule. In one 2017 meta-analysis published in the European Journal of Preventive Cardiology, for instance, researchers concluded that insomniacs have an increased risk of both heart attack and stroke. According to their findings, difficulty maintaining sleep is associated with an 11 percent increased risk of cardiovascular disease, while non-restorative sleep leads to an 18 percent increased risk.
Having sleep apnea
The National Sleep Foundation explains that when your sleep is disrupted by apnea, it increases your risk of hypertension. "Blood pressure will go up because when you're not breathing, the oxygen level in your body falls and excites receptors that alert the brain," they explain. And while sleep apnea is a heart risk factor that can affect people of all ages, it most commonly affects men over the age of 40—especially those who are overweight.
Having too many doctors
Because the risk of conflicting medications is that much greater when you see different specialists for different concerns, the American Heart Association points out that seeing too many doctors can be a counterintuitive risk factor for poor heart health. If you find yourself with multiple medical professionals at the helm, make sure there is adequate communication between them, or bring your medical records from one appointment to the next.
Foregoing blood thinners
While too many medications can lead to cardiovascular concerns, Dr. Shephal Doshi, director of cardiac electrophysiology at Providence Saint John's Health Center in Santa Monica, California, says that a lack of one particular medication—blood thinners—can also harm your heart.
"Studies have consistently shown an underuse of stroke prevention medications, such as blood thinners," in patients with heart health issues, he says. While, like any medication, there are some potential complications related to the use of blood thinning medication, "the benefit of blood thinners is generally greater than the risk" for people over 40, he explains.
Having had preeclampsia
Preeclampsia is a dangerous condition in which pregnant women experience high blood pressure. According to the Mayo Clinic, this can greatly complicate a pregnancy by causing eclampsia, stroke, placental abruption, and preterm delivery of the baby. But one lesser known complication can present long after the baby is born: increased risk of cardiovascular failure later in life.
A 2014 study published in Circulation indicates that those with preeclampsia during their pregnancy are at greater risk for heart failure down the line. And while preeclampsia can affect pregnant women of all ages, advanced maternal age is considered one of the highest risk factors for this condition.
Having atrial fibrillation
According to Doshi, the over-40 set should be on the lookout for signs of atrial fibrillation (AF). As he explains, "The median age for patients with atrial fibrillation is 66.8 years for men and 74.6 years for women." That's exactly why signs of AF in the relative youth of your 40s could indicate a more serious condition, like valvular heart disease.
Because AF can lead to a life-threatening pulmonary embolism, symptoms indicating atrial fibrillation, like heart palpitations, weakness, dizziness, shortness of breath, and confusion, should always be taken seriously.
Having unhealthy drinking habits
Drinking in excess can result in a whole host of health problems, but many people don't realize that among them are heart disease, cardiomyopathy, cardiac arrhythmia, and higher rates of obesity and diabetes. The American Heart Association recommends that men limit their alcohol intake to one to two drinks per day, and women restrict themselves to a single drink per day.
The effects of excessive drinking tend to catch up to you in your 40s, but if you're still a heavy drinker, it's not too late to turn your health around: According to a 2016 study in Oxford Journals Alcohol and Alcoholism, research on subjects aged 40 to 69 found that there is "no significant difference in health status between former drinkers and lifetime abstainers."
Having anger control issues
According to a 2000 study published in Circulation, how prone you are to anger can be a major risk factor for coronary heart disease (CHD) and death from a heart-related issue. But just how much greater is the risk for those struggling to control their anger? The study found that the risk of combined coronary heart disease was twice as great for those with high anger levels, while the risk of fatal heart issues was three times greater than that of those with a low level of anger.
Having an autoimmune disease
There are several conditions that can lead to cardiomyopathy, a disease of the heart muscle that hardens the coronary tissue: heart damage, thyroid problems, and muscular conditions like muscular dystrophy, to name just a few. Yet one potential cause, autoimmune disease (AD), tends to be under-acknowledged, perhaps because of how misunderstood autoimmune conditions are, with patients frequently being labelled "chronic complainers" in the absence of a clear diagnosis. The CDC explains that autoimmune diseases, such as connective tissue disease, can have the same ultimately damaging impact on the heart, and most people with AD (75 percent of whom are women) will have symptoms before the age of 45.
Having a family history of heart disease
If you have a family history of heart disease, you have crucial clues about your own heart health right at your fingertips. If your father had a major heart event before the age of 55, or your mother had one before 65, your chances of experiencing heart failure or cardiovascular disease at some point in your life are significantly higher.
A 2016 study published in PLoS One indicates that maternal history is the most reliable predictor of onset age for cardiovascular disease in the next generation. And to stay healthy in the future, make sure you tell your physician these 10 Things Doctors Say Patients Should Tell Them But They Never Do.
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