Heart Health by the Decades: Expert advice from a Hoag cardiologist
Protecting your heart looks different at every stage of life. Kevin Kheder, MD, an interventional cardiologist at Hoag’s Jeffrey M. Carlton Heart & Vascular Institute, shares what to prioritize in your 20s, 30s, 40s, 50s, 60s, and beyond to reduce risk, catch warning signs early, and maintain lifelong heart health.
Your 20s: Laying the Foundation According to Dr. Kheder, the 20s are about building habits that last a lifetime. Regular exercise, avoiding smoking or vaping, limiting processed foods and added sugars, and prioritizing sleep all help protect the heart. He recommends baseline screenings in early adulthood—blood pressure, cholesterol, and glucose—which should be repeated every four to six years if normal.
“These simple steps can help prevent silent changes like elevated blood pressure or insulin resistance that often begin in this decade,” he notes.
Your 30s: Managing Stress and Building Balance “This is often the most stressful decade of life,” says Dr. Kheder.
Careers, families, and responsibilities are in full swing, and chronic stress can raise blood pressure, fuel inflammation, and encourage unhealthy coping. He emphasizes that managing stress through exercise, mindfulness, therapy, and healthy boundaries is not a luxury—it’s a key protective measure for the heart.
Your 40s: Knowing Your Numbers By midlife, Dr. Kheder stresses the importance of tracking cholesterol, blood pressure, glucose, and body mass index more closely. Blood pressure should be checked at least annually, and cholesterol and glucose every three to five years if normal.
“Coronary artery disease can begin to manifest in this decade, even without symptoms,” he explains.
Proactive monitoring helps catch issues before they escalate.
Your 50s: Recognizing Warning Signs and Hormonal Changes “Many patients dismiss early cardiovascular symptoms as just stress or aging,” Dr. Kheder cautions.
Fatigue, shortness of breath, indigestion, erectile dysfunction, or jaw pain could be red flags. For women, menopause marks a turning point as estrogen’s protective effects on blood vessels decline, while for men, declining testosterone can alter cholesterol and body composition.
Dr. Kheder advises using this decade to reassess risks and adjust lifestyle or treatment plans accordingly.
Your 60s: Balancing Prevention and Management By this stage, many people are managing conditions like hypertension, diabetes, or atrial fibrillation.
“Prevention still matters, but the focus now is on tightly managing existing conditions to avoid complications like heart attack or stroke,” says Dr. Kheder.
Medication adherence, diet, exercise, and follow-up care become essential, and additional screenings such as coronary calcium scoring or echocardiograms may be recommended.
Your 70s and Beyond: Prioritizing Quality of Life “In the 70s and later, the emphasis is on maintaining independence and quality of life,” Dr. Kheder explains.
Simplifying medications, focusing on mobility and strength, and ensuring coordination between providers become top priorities.
He stresses that nutrition, exercise, and supportive care plans remain important, but the ultimate goal is helping patients live well, not just longer.
