Heart disease, high blood pressure and other chronic conditions over 60: What to know and how to improve your health

At 68, Patrick Jones relished an active retirement filled with adventure and travel. But days before the Baldwin resident and his wife were set to jet off for a five-day vacation to Colombia, the former engineer said he underwent planned pre-operative testing for shoulder surgery to repair an old work injury.

After acing both an EKG and a stress test, Jones’ doctor asked him if he had a family history of heart disease. “I told him my mother had open-heart surgery 13 years ago,” said the father of three. “The doctor said, ‘Let’s just do one more test.’ ”

A scan of Jones’ heart revealed a blockage in a coronary artery, he said. “The doctor sent me to the hospital immediately for a diagnostic procedure,” said Jones, who noted that up to that point, he had been healthy and never had chest pain or breathing difficulties.

“But after that test there, the cardiologist told me I had a 90% blockage in the main coronary artery, called the widow-maker, and he implanted a stent [to restore blood flow to the heart] and prescribed a couple of medications,” Jones said.

Ninety-five percent of older adults develop at least one chronic health condition by age 60, according to research by the nonprofit National Council on Aging in Arlington, Virginia, and the University of Massachusetts in Boston. Nearly 80% of older adults have two or more chronic conditions.

Health challenges can impact quality of life, causing anxiety and depression. But experts said many of these diseases and conditions that crop up later in life can be managed or controlled through lifestyle modification and medications.

Coronary heart disease is among the top five most common chronic conditions in older adults, along with high cholesterol, obesity, arthritis and high blood pressure, said Dr. Suzanne Fields, a geriatrician and co-director of Stony Brook University’s Center for Healthy Aging at the Renaissance School of Medicine. She added that other common conditions include diabetes, kidney disease, depression, heart failure, Alzheimer’s disease and dementia and osteoporosis, which weakens the bones.

FEELING LUCKY

Jones’ diagnosis came as a shock, but he said he is grateful that early intervention saved his life. “Before this, I thought I was basically healthy,” he said. “The first couple of weeks, I was contemplating what could have been . . . I could have died.”

A 2014 study of nearly 100 centenarians, published in The Journals of Gerontology, found that more than 20% of the people who reached age 100 did so without developing a major chronic disease. Nevertheless, experts said most older adults will likely not be so lucky.

“As you age, there are many process changes at work,” said Dr. Matthew C. Mulroy, a geriatrician with UCLA Health. “Cells don’t turn over as frequently and work inefficiently, muscles lose mass, blood vessels become stiffer, the heart is less efficient, kidneys shrink and joints degenerate.”

Fran Shandel, 81, of Mount Sinai, knows well the physical realities of aging. The retired elementary school teacher said she was an avid hiker, climbing mountains throughout the United States, Canada and Eastern Europe. In her 70s, she said she developed high blood pressure that was well-controlled by medication. Then last year, at age 80, her smartwatch detected atrial fibrillation, a serious irregular heartbeat that can lead to stroke, heart failure and blood clots.

To Shandel’s dismay, doctors confirmed the diagnosis, prescribed medications and recommended a diet limiting salt and caffeine. “Now, I get a little dizzy when I lose my breath . . . I can’t walk as far or fast because I get winded,” said the grandmother of seven, who now uses a cane.

Since chronic illness has become part of Shandel’s life, hiking mountain ranges and trips abroad are now off the table. “I won’t go into the city as much because there is too much walking, and I won’t travel to Europe anymore because I don’t want to be elsewhere and get sick,” she said.

Experts said the onset of chronic illness, especially if it interferes with an individual’s lifestyle, often leads to anxiety, anger and depression.

“Your first instinct is to avoid and retreat,” said Norman Miller, an adjunct associate professor of psychology at Hofstra University in Hempstead. “Multiple chronic illnesses can cause you to become anxious and depressed and have self-pity, causing someone to question, ‘Why is this happening?’ And that can lead to substance abuse and other [destructive] behaviors.”

USED TO BEING FIT

When Barbara Reddy, of Holbrook, was an Internal Revenue Service analyst, she said she went to the gym most nights after work and loved to travel.

As she aged, Reddy said she noticed that several chronic health conditions began cropping up. She was first diagnosed with high blood pressure at age 65 during a regular checkup. When she turned 70, she developed a slow thyroid. Then at 83, doctors told her she had Type 2 diabetes.

Reddy, now 87, said she dislikes taking medication and is happy that she can manage her high blood sugar through diet alone. She had hoped adjusting her diet would also improve her blood pressure, “but it didn’t work,” she said.

On top of her recent health setbacks, Reddy said her balance has become increasingly unsteady, and she has experienced a few falls. “One time I was walking in a shopping center parking lot with a cart and a car backed up and hit the cart and I fell,” Reddy recalled. “I went to the hospital with a big bump on my head and two black eyes.”

Now, she walks with a rollator — a wheeled walker with a built-in seat — that her doctor recommended and has been attending physical therapy. But, she said, travel is no longer an option. Not only does Reddy fear falling again, but she said, “All the walking that’s required with traveling would be too much, and I don’t want to hold anyone up.”

Despite her physical limitations, Reddy said she is hopeful she can make progress through physical therapy and enjoys socializing with friends and family, especially spending time with her granddaughter.

‘SMALL STEPS’

Experts said while age and genetics are unchangeable factors, adjustments can be made to daily routines to improve health and well-being.

“It’s important to help older adults recognize that even small steps, like being a little more active or choosing a variety of healthy foods, can make a powerful difference in how they feel in their energy level and frame of mind. … You don’t need to make dramatic change to improve your quality of life,” said Dorothea Vafiadis, senior director of the National Council on Aging’s Center for Healthy Aging.

Mulroy, the UCLA Health geriatrician, echoed that advice. “Lifestyle changes are one of the things in our control,” he said. “Exercise, nutrition, avoiding smoking and other lifestyle factors work to prevent chronic conditions.”

He noted as an example a patient in his practice who was experiencing falls. Mulroy said he expressed concern that one might lead to an injury that “they might not recover from.” After the patient started physical therapy and diligently practiced the exercises at home, he said, “They came back to me with a sense of accomplishment and felt more energetic.”

Developing coping strategies and challenging negative thoughts can help ward off anxiety and depression that may accompany chronic diseases and conditions, said Miller, of Hofstra University. “Don’t allow the illness to define you,” he said. “You define what you can do, not what you can’t do.”

Although Shandel is no longer able to power-walk two miles each day, she said she remains focused on the positive. She said she enjoys visiting with her grandchildren and playing cards with her friends at her 55-plus community.

“I don’t regret what I can’t do. I’m appreciative of what I can do,” she said.