In their 50s and 60s, most people have developed some awareness of heart health. Regular exercise, a Mediterranean-style diet, and managing stress are helpful tools in maintaining general health and avoiding heart problems.
However, heart and vascular care can shift significantly with aging, making it essential to understand the distinct biological dialects of the heart.
The After-50 Shift: How Heart Health Changes Differ in Men and Women
In the past, heart disease typically focused mostly on men as estrogen generally offers women a layer of protection. However, hormonal protection diminishes with menopause, causing an increase in a woman’s cardiovascular risk. By age 70, women’s risk of atherosclerosis is the same as men.
There is also a gender divide in the biology of how disease progresses. Men typically develop "plumbing issues"— large, central blockages in the major epicardial arteries. Men may experience symptoms such as crushing chest pressure, while women tend to develop disease in the microvasculature—the tiny, branching vessels that feed the heart muscle. Though advanced diagnostic tools can detect "small vessel disease," a specialized approach is still necessary. Both men and women may still experience a cardiac event, even with a normal standard angiogram procedure.
Heart Warning Signs: Men vs. Women
It’s crucial to pay attention to symptoms at any age, but especially over 50, where heart symptoms may be mimic other conditions. For men, the "classic" sharp or heavy chest pain often described as “pressure” radiating down the left arm, often accompanied by a cold sweat remains the primary red flags and warrants a call to 911.
Dismissing symptoms as “nothing” is a mistake commonly made by women, who experience a sense of profound, unexplained exhaustion—the kind where suddenly a casual walk causes symptoms such as shortness of breath, nausea, indigestion, recurring episodes of abdominal pain or a nagging ache between the shoulder blades or in the jaw. Often, these may be dismissed as stress, getting older or a virus. In fact, research shows that women may experience these "pre-warning" signs weeks before a major cardiac event occurs.
Know Your Numbers: The 2026 Cardiac Report Card
For any adult over 50, a "Numbers Check" should be an annual priority. Clinical standards have tightened based on new longitudinal data. Here’s what we need to know:
- Blood Pressure: The "silent killer" remains a primary adversary. Updated guidelines strongly recommend a target of less than 120/80 mmHg. For numbers consistently over 130, arteries are under unnecessary stress. This can be easily tracked by using the AHA Blood Pressure Categories. An elevated reading can range from 120 to 129 (systolic) and below 80 (diastolic).
- Stage 1 Hypertension ranges from 130 to 139 (systolic) or 80 to 89 (diastolic).
- Stage 2 Hypertension ranges from 140 or higher (systolic) or 90 (diastolic).
- Hypertensive Crisis is a reading higher than 180 (systolic) and/or 120 (diastolic) and should be evaluated by your provider immediately.
- LDL Cholesterol: This is often known as the “bad” cholesterol. For most seniors, the levels should be less than 100 mg/dL, but if there are existing risk factors like diabetes or a family history, the goal is now an aggressive 55 mg/dL.
- Lipoprotein (a): A fatty cholesterol particle that circulates in the bloodstream, lipoprotein(a) is similar to LDL cholesterol but more dangerous. High levels of Lp(a), as it is commonly called, can double or even triple a person's risk of a heart attack. It's considered a common culprit in heart disease that occurs at a young age.
- Blood Sugar (A1c): Diabetes is a massive accelerator for heart disease, especially in women. Aim for an A1c under 5.7% to keep vessels healthy.
- Waist Circumference: Central obesity is a major driver of arterial stiffness and metabolic syndrome. Aim for less than 35 inches for women and 40 inches for men.
The Importance of Advocacy and Treatment
Despite scientific advancements, a treatment gap persists in modern medicine. Statistics continue to show that women wait longer in emergency departments and are less likely to be prescribed life-saving statins or aspirin than men with identical risk profiles.
It is important for seniors to be their own advocate and speak up when something feels wrong by specifically stating, "I am concerned these symptoms are cardiac in nature, and I’d like to rule out a heart event."
Regardless of gender, the most powerful tool is knowing the recommended numbers and listening to symptoms.
From simple screenings to advanced treatment, Trinitas Regional Medical Center offers the following:
- Diagnostic Center: Aconvenient, modern, all-in-one center is located near the main lobby for easy access to inpatient and outpatient testing, including EKG, cardiac stress testing, echocardiograms, vascular studies, and coronary CTA.
- Minimally Invasive Expertise: A fully licensed Cardiac Catheterization and Elective Percutaneous Coronary Intervention (PCI) Lab provides state-of-the-art advanced techniques, devices, and procedures to treat complex cardiovascular and vascular conditions.
- Dedicated Team: Board-certified Heart, Vascular, and Cardiothoracic specialists assist in diagnosing and treating cardiovascular conditions, ensuring patients receive the highest level of comprehensive and compassionate care.
No one plans on heart problems. But everyone should have a plan for them.
Get checked today.
