Heart of heart after 50: Prevention and maintenance

Heart of heart after 50: Prevention and maintenance

I. Anatomy and physiology of the aging heart

A. Structural changes: The heart, like any other organ, is subjected to structural changes with age.

1. Improvement of myocardial mass: After 50 years, a gradual increase in myocardial mass occurs, especially the left ventricle. This increase is associated with compensatory hypertrophy caused by various factors, such as increasing blood pressure, increasing the rigidity of arteries and impaired diastolic function. Myocardial hypertrophy can lead to a decrease in the elasticity of the heart muscle and the deterioration of its ability to relax, which affects the diastolic content of ventricles.

2. Increase in the size of the atrial: The atrium also increases in size with age. This increase may be associated with an increase in pressure in the atria caused by disorders of the diastolic function of the left ventricle or valve defects. An increase in atrial increases the risk of atrial fibrillation, common arrhythmia in older people.

3. Thickening of the walls of the heart valves: The heart valves, especially the aortic and mitral, become thicker and thicker with age. This is due to the deposition of calcium and collagen in valve sash. A thickening of the valves can lead to their stenosis (narrowing) or insufficiency (incomplete closure), which disrupts normal blood flow through the heart.

4. Lipofuscin deposition in cardiomyocytes: Lipofuscin, aging pigment, accumulates in cardiomyocytes (heart cells) with age. A significant deposition of lipofuscin can disrupt the function of cardiomyocytes and reduce their ability to reduce.

5. Reducing the number of cardiomyocytes: With age, there is a gradual decrease in the number of cardiomyocytes, since old cells die, and new ones form more slowly. Loss of cardiomyocytes can reduce the contractility of the heart.

6. Increase in the amount of connective tissue (fibrosis): The amount of connective tissue in the myocardium increases with age. This leads to fibrosis, that is, the replacement of the normal heart tissue of the scar. Fibrosis reduces the elasticity of the heart muscle and worsens its ability to reduce and relax.

B. Functional changes: Age -related changes in the structure of the heart lead to functional disorders.

1. Reduced maximum heart rate (heart rate): The maximum heart rate that the heart can achieve during physical activity decreases with age. This is due to changes in the syno) node (the main driver of the heart rhythm) and a decrease in the sensitivity of the heart to adrenaline. A decrease in the maximum heart rate can limit the physical performance of older people.

2. Diastolic function deterioration: The diastolic function, that is, the ability of the heart is relaxed and filled with blood between contractions, worsens with age. This is due to an increase in myocardial rigidity and a violation of calcium metabolism in cardiomyocytes. The deterioration of diastolic function can lead to an increase in pressure in the atria and lungs, causing shortness of breath and swelling.

3. Reducing contractile ability: The contractile ability of the heart, that is, the force with which the heart is reduced, can decrease with age, although in most cases it remains within the norm at rest. However, during physical activity, the ability of the heart to increase the strength of contractions can be reduced.

4. Increase in the rigidity of arteries (arteriosclerosis): Arteries become more stringent and less elastic with age, which leads to an increase in blood pressure and an increase in the load on the heart. Arteriosclerosis also contributes to the development of atherosclerosis (the formation of plaques in the arteries).

5. Reducing the sensitivity of baroreceptors: Barooreceptors located in the arteries control blood pressure. Their sensitivity decreases with age, which can lead to fluctuations in blood pressure and an increase in the risk of orthostatic hypotension (falling blood pressure during risk).

6. Endotothelia function: Endothelium, the inner layer of arteries, plays an important role in the regulation of vascular tone and preventing blood clots. The endothelium function worsens with age, which contributes to the development of atherosclerosis and other cardiovascular diseases.

II. Risk factors for cardiovascular diseases after 50 years

A. Modified risk factors: Risk factors that can be influenced by changing lifestyle or drug treatment.

1. High blood pressure (hypertension): Hypertension is one of the most important risk factors for cardiovascular diseases, especially after 50 years. Increased blood pressure exerts an additional burden on the heart, damages the arteries and promotes the development of atherosclerosis. Regular measurement of blood pressure and its control by changing lifestyle and drug treatment are necessary for the prevention of cardiovascular diseases. The target values ​​of arterial pressure for the elderly are usually lower than for young people, but should be determined by an individual by a doctor.

2. High cholesterol (hyperlipidemia): A high level of cholesterol, especially low density lipoproteins (LDL, “bad” cholesterol), contributes to the formation of atherosclerotic plaques in the arteries. A decrease in the level of LDL with a diet, physical exercises and, if necessary, statins, is an important part of the prevention of cardiovascular diseases. Regular blood test for a lipid profile allows you to identify hyperlipidemia and begin timely treatment.

3. Smoking: Smoking is a powerful risk factor for cardiovascular diseases. Nicotine and other chemicals contained in tobacco smoke damage arteries, increase blood pressure, reduce high density lipoproteins (HDL, “good” cholesterol) and increase the risk of blood clots. The cessation of smoking, regardless of age, has an immediate and significant positive effect on the health of the heart.

4. Diabetes sugar: Diabetes mellitus significantly increases the risk of cardiovascular diseases. The high level of blood sugar damages arteries, promotes the development of atherosclerosis and increases the risk of blood clots. Monitoring the blood sugar with a diet, physical exercises and drug treatment is an important part of the prevention of cardiovascular diseases in people with diabetes.

5. Obesity: Obesity, especially abdominal (deposition of fat in the abdomen), is associated with an increased risk of cardiovascular diseases. Obesity contributes to the development of hypertension, hyperlipidemia, diabetes and insulin resistance. Reducing weight with a diet and physical exercises can significantly improve heart health.

6. Insufficient physical activity: Insufficient physical activity is a risk factor for cardiovascular diseases. Regular physical exercises strengthen the heart muscle, reduce blood pressure, improve cholesterol, help control weight and reduce the risk of diabetes. It is recommended at least 150 minutes of moderate or 75 minutes of intensive aerobic activity per week, as well as exercises to strengthen muscles twice a week.

7. Inal meals: Improper nutrition, rich in saturated and trans fats, cholesterol, salt and sugar, increases the risk of cardiovascular diseases. A healthy diet, rich in fruits, vegetables, whole grain products, low-fat protein and healthy fats, can reduce the risk of cardiovascular diseases.

8. Chronic stress: Chronic stress can increase blood pressure, increase cholesterol and contribute to the development of atherosclerosis. Stress management using relaxation techniques, yoga, meditation and sufficient sleep can improve heart health.

B. Unmodified risk factors: Risk factors that cannot be influenced.

1. Age: The risk of cardiovascular diseases increases with age. Age-related changes in the structure and functions of the heart and arteries make the elderly more susceptible to cardiovascular diseases.

2. Floor: Men are usually at greater risk of cardiovascular disease than women, especially to menopause. After menopause, the risk of cardiovascular diseases in women increases and approaches risk in men.

3. Family history: The presence of cardiovascular diseases in close relatives (parents, brothers, sisters) increases the risk of developing these diseases. This may be associated with a genetic predisposition or general lifestyle factors.

4. Race/ethnicity: Some races and ethnic groups are at greater risk of cardiovascular diseases than others. For example, African Americans have a higher risk of hypertension and heart failure than white.

III. Common cardiovascular diseases after 50 years

A. Corny heart (coronary heart disease):

1. Stenocardia: Pain in the chest caused by insufficient blood supply to the heart muscle. Angina pectoris can be stable (occurs with physical exertion) or unstable (occurs at rest or at a minimum load and is a sign of increased risk of myocardial infarction).

2. Myocardial infarction (heart attack): Damage to the heart muscle caused by a complete or almost complete cessation of blood supply. Myocardial infarction can lead to death or serious complications, such as heart failure and arrhythmias.

3. Besmptomatic ischemia: Insufficient blood supply to the heart muscle, which does not cause chest pain. Asymptomatic ischemia can be detected by electrocardiography (ECG) or other research methods.

B. Heart failure:

1. Sistolic heart failure: The heart cannot contract quite strongly to pump blood in sufficient volume.

2. Diastolic heart failure: The heart cannot relax quite well and be filled with blood.

3. Symptoms of heart failure: Shortness of breath, fatigue, swelling of the legs and ankles, a rapid heartbeat, cough, wheezing.

C. Arrhythmias:

1. Atrial fibrillation: An irregular and frequent heartbeat arising in the atria. Atrial fibrillation increases the risk of stroke and heart failure.

2. Ventricular tachycardia: Fast heartbeat arising in ventricles. The ventricular tachycardia can be life -threatening and lead to sudden heart death.

3. Bradycardia: Too slow heartbeat. Bradycardia can cause fatigue, dizziness and fainting.

D. Heart valves:

1. Aortic stenosis: Narrowing of the aortic valve, which prevents normal blood flow from the heart to aorta.

2. Mitral failure: The incomplete closing of the mitral valve, allowing blood to return from the left ventricle to the left atrium.

3. Aortic deficiency: The incomplete closure of the aortic valve, allowing blood to return from the aorta to the left ventricle.

E. Stroke:

1. Ischemic stroke: A stroke caused by blockage of the artery supplying the brain with blood.

2. Hemorrhagic stroke: A stroke caused by hemorrhage in the brain.

F. Diseases of the peripheral arteries (ZPA):

1. Atherosclerosis of the arteries of the lower extremities: Narrowing of the arteries that supply the legs and feet. ZPA can cause pain in the legs when walking (intermittent chromium), numbness and cooling of the legs, as well as the risk of developing ulcers and gangrene.

IV. Diagnosis of cardiovascular diseases

A. Anamnesis and physical examination: The doctor asks questions about the symptoms, medical history and family history. During a physical examination, the doctor measures blood pressure, pulse, listens to the heart and lungs.

B. Electrocardodiography (ECG): Recording electrical activity of the heart. ECG can identify arrhythmias, myocardial ischemia and other heart diseases.

C. Echocardiography (ultrasound of the heart): Using ultrasound to obtain an image of the heart. Echocardiography allows you to evaluate the size and function of the heart chambers, the condition of the valves and the presence of liquid in the pericardium.

D. Exercise tests: ECG or echocardiography during physical activity. Strong tests help identify myocardial ischemia, which may not manifest itself alone.

E. Holter monitoring ECG: Continuous ECG recording for 24-48 hours. Holter monitoring of ECG allows you to identify transient arrhythmias that may not be detected with a conventional ECG.

F. Daily monitoring of blood pressure (SMAD): Continuous measurement of blood pressure within 24 hours. Father allows you to evaluate the daily fluctuations in blood pressure and detect hypertension, which may not be detected in one -time dimensions.

G. Coronary angiography (catheterization of the heart): The introduction of a catheter into the arteries of the heart to obtain x -rays. Coronary angiography allows you to identify narrowing and blockage in coronary arteries.

H. Computed tomography (CT) of the heart: The use of x -rays to obtain detailed images of the heart and coronary arteries. CT of the heart can be used to detect calcification of coronary arteries and assess the risk of cardiovascular diseases.

I. Magnetic resonance imaging (MRI) of the heart: Using magnetic fields and radio waves to obtain images of the heart. MRI of the heart allows you to evaluate the structure and function of the heart, identify signs of inflammation and fibrosis.

J. Blood tests:

1. Lipid profile: Measurement of cholesterol, LDL, HDL and triglycerides.

2. Glucose: Measurement of blood sugar.

3. Creatinin and urea: Measurement of kidney function.

4. Electrolytes (potassium, sodium, calcium): Measurement of the level of electrolytes in the blood.

5. Troponin: Protein, which is released into the blood in case of damage to the heart muscle. Troponin level measurement is used to diagnose myocardial infarction.

6. STRIURETIC PEPTIDE (BNP or NT-PROBNP): The hormone that is released in the blood with heart failure. The measurement of the BNP or NT-PROBNP level is used to diagnose and evaluate the severity of heart failure.

V. Prevention of cardiovascular diseases after 50 years

A. Life change change:

1. Healthy nutrition:

   a. Mediterranean diet: Rich in fruits, vegetables, whole grain products, olive oil, fish and low -fat protein. Limiting the consumption of red meat, processed products and sugar.

   b. Restriction of saturated and trans fats: These fats increase the level of LDL cholesterol. Limiting the consumption of fatty meat, fried products, baking and processed products.

   c. Useful fat consumption: Polynaturated and mono-saturated fats (omega-3 fatty acids) can reduce cholesterol LDL and the risk of cardiovascular diseases. Sources of healthy fats: fish (salmon, tuna, sardines), nuts, seeds, avocados and olive oil.

   d. Salt restriction: High salt consumption increases blood pressure. Limiting the consumption of processed products, salted appetizers and adding salt during cooking. It is recommended to use herbs and spices to give the taste of food.

   e. Sugar restriction: High sugar consumption increases the risk of obesity, diabetes and cardiovascular diseases. Limiting the consumption of sweet drinks, sweets, baking and processed products.

   f. Increase in fiber consumption: Fiber helps reduce cholesterol and control blood sugar. Sources of fiber: fruits, vegetables, whole grain products and legumes.

2. Regular physical exercises:

   a. Aerobic exercises: Exercises that increase heart rate and improve the function of the cardiovascular system. Examples: walking, running, swimming, cycling and dancing. At least 150 minutes of moderate or 75 minutes of intensive aerobic activity per week are recommended.

   b. Power exercises: Exercises that strengthen the muscles. Examples: weight lifting, using elastic tapes and exercises with your own weight. It is recommended to perform strength exercises twice a week.

   c. Flexibility and balance: Exercises that improve flexibility and balance help to prevent falls. Examples: yoga, tai-chi and stretching.

   d. Warm up and hitch: Before and after the end of the training, it is important to perform a warm -up and hitch in order to prepare the muscles for the load and prevent injuries.

   e. Consultation with a doctor: Before starting a new program of physical exercises, it is recommended to consult a doctor, especially if you have any diseases.

3. Maintaining a healthy weight:

   a. Determination of the body mass index (BMI): BMI is an indicator that is calculated on the basis of growth and weight and is used to assess weight. BMI from 18.5 to 24.9 is considered normal.

   b. Weight loss if necessary: If you have overweight or obesity, weight loss can improve heart health. A weight loss even by 5-10% can have a significant positive effect on blood pressure, cholesterol and blood sugar.

   c. Healthy nutrition and physical exercises: The best way to reduce weight is a combination of healthy nutrition and regular physical exercises.

4. Termination of smoking:

   a. Consultation with a doctor: The doctor can offer various methods of treatment that will help you quit smoking, such as nicotine plasters, chewing gums and tablets.

   b. Support groups: Participation in support groups can help you get support and motivation necessary to quit smoking.

   c. Avoiding triggers: Avoid situations that make you want to smoke.

5. Alcohol use restriction:

   a. Moderate alcohol consumption: If you drink alcohol, do it moderately. Moderate drinking of alcohol means no more than one drink per day for women and no more than two drinks per day for men.

   b. Abstinence from alcohol: If you have any diseases in which alcohol is not recommended, you should refrain from drinking alcohol.

6. Stress management:

   a. Relaxation techniques: Meditation, yoga, deep breathing and progressive muscle relaxation.

   b. Hobbies and interests: Classes that bring pleasure and help to relax.

   c. Communication with friends and family: Support from loved ones can help cope with stress.

   d. Sufficient sleep: A lack of sleep can aggravate stress. Try to sleep at least 7-8 hours a day.

B. Medication:

1. Statin: Reduce the level of LDL cholesterol.

2. Antihypertensive drugs: Reduce blood pressure. There are several classes of antihypertensive drugs, such as angiotensin-converting enzyme inhibitors (IAC), angiotensin II (sconces) receptors, beta-blockers, diuretics and calcium channel blockers.

3. Antiagragash (aspirin, blopidognosidel): Prevent blood clots. Aspirin in low doses can be recommended for the prevention of cardiovascular diseases in people with high risk.

4. Anticoagulants (warfarin, dabigatran, rivaroxaban, Apixban): Prevent blood clots. Anticoagulants can be prescribed to people with atrial fibrillation, deep vein thrombosis or other diseases in which there is an increased risk of blood clots.

5. Drugs for the treatment of diabetes: Insulin, metformin and other drugs that help control blood sugar.

C. Regular medical examinations:

1. Measurement of blood pressure: Regular measurement of blood pressure allows you to identify hypertension in the early stages and begin timely treatment.

2. Blood test for a lipid profile: Regular blood test for a lipid profile allows you to identify hyperlipidemia and begin timely treatment.

3. Electrocardodiography (ECG): Regular ECG can detect arrhythmias and other heart diseases.

4. Consultation with a doctor: Regular consultations with a doctor allow us to discuss issues of prevention of cardiovascular diseases and get individual recommendations.

D. Vaccination:

1. Influenza vaccination: Influenza can increase the risk of cardiovascular complications. Regular flu vaccination is recommended for people with cardiovascular diseases.

2. Vaccination from pneumococcal infection: A pneumococcal infection can increase the risk of cardiovascular complications. Vaccination from pneumococcal infection is recommended for people with cardiovascular diseases.

VI. Life with cardiovascular diseases after 50 years

A. Compliance with the doctor’s recommendations:

1. Meding in accordance with the appointment of a doctor: It is important to take medicines in accordance with the doctor’s prescription and not to miss the medication.

2. A visit to a doctor for regular examinations: Regular examinations at the doctor allow you to control the state of health and adjust the treatment if necessary.

3. Message to the doctor about any new symptoms or changes in health status: It is important to inform the doctor about any new symptoms or changes in the state of health so that the doctor can evaluate your condition and adjust the treatment if necessary.

B. Life lifestyle adaptation:

1. Diet change: Compliance with a healthy diet rich in fruits, vegetables, whole grain products and low -fat protein.

2. Regular physical exercises: Performing regular physical exercises in accordance with the recommendations of the doctor.

3. Stress management: The use of relaxation techniques for stress control.

4. Refusal of smoking and restriction of alcohol use: Refusal of smoking and restriction of alcohol use.

C. Psychological support:

1. Communication with family and friends: Support from loved ones can help cope with emotional difficulties associated with cardiovascular diseases.

2. Participation in support groups: Participation in support groups can help you get support and tips from other people living with cardiovascular diseases.

3. Consultation with a psychologist or psychotherapist: Consultation with a psychologist or psychotherapist can help you cope with anxiety, depression and other emotional problems.

D. Heart rehabilitation:

1. Heart rehabilitation programs: The rehabilitation programs of the heart help people recover after a heart attack, heart surgery or other cardiovascular diseases. The rehabilitation programs of the heart include physical exercises, educational classes and psychological support.

VII. New directions in the prevention and treatment of cardiovascular diseases

A. Genetic research: The identification of genes associated with an increased risk of cardiovascular diseases can help in the development of individual prevention and treatment strategies.

B. Personalized medicine: Development of prevention and treatment strategies based on the individual characteristics of each person, such as a genetic profile, lifestyle and concomitant diseases.

C. Innovative treatment methods:

1. Transcate implantation of the aortic valve (TAVI): The minimally invasive procedure in which the aortic valve is replaced through a catheter introduced into the artery.

2. Mitraklip: The minimally invasive procedure in which the mitral valve is fixed using a clip to reduce mitral deficiency.

3. Stimulation of the vagus nerve: Stimulation of the vagus nerve can reduce blood pressure and improve the function of the heart.

D. Artificial intelligence (AI) in cardiology: AI can be used to analyze the ECG, echocardiograms and other medical data to identify signs of cardiovascular diseases in the early stages.

E. Telemedicine: Telemedicine allows patients to receive consultations and treatment from doctors remotely using video communication and other technologies. Telemedicine can be especially useful for people living in remote areas or having limited mobility.

VIII. Conclusion

Heart of heart after 50 years requires increased attention and active measures for prevention and maintenance. Change in lifestyle, drug treatment and regular medical examinations can significantly reduce the risk of cardiovascular diseases and improve the quality of life. Modern achievements in the field of genetics, personalized medicine and innovative treatment methods open up new opportunities for the prevention and treatment of cardiovascular diseases. Active participation in maintaining your own health, compliance with the doctor’s recommendations and the use of modern technologies allow you to maintain heart health and live a long and full life.