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Ageing well: how to keep your heart healthy

What works to lower cholesterol and blood pressure, and the health myths to ignore

Heart disease causes a quarter of all UK deaths each year, and older people are more at risk. 

This is because, with age, blood vessels and arteries naturally stiffen and your heart has to work harder to pump blood around your body. 

Your heart muscles do adapt, but high blood pressure and high cholesterol can make things worse, and are the two main risk factors for heart disease.

While some things are beyond our control, such as our genetic makeup, there are lifestyle changes you can make to reduce your risk, and the evidence shows you're never too young to start.

We've rounded up the top science-backed tips for looking after your heart health, and the headline-grabbing myths to disregard.

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Monitoring your heart health

Usually, you won’t know you have high blood pressure or high cholesterol as there aren’t any obvious symptoms, so you need to have them measured. 

Your GP, or sometimes pharmacist, can do this and you should have these checked regularly after 40, a straightforward service which is free as part of the NHS Health Check.

High blood pressure: what you can do

1. Eat more fruit and veg

fruit and vegetables

Fruit and veg contain potassium which lowers blood pressure and counters the effect of salt (sodium).

They're also high in fibre; certain fibres help to prevent cholesterol being absorbed into your bloodstream. Diets high in fruit, veg and fibre are linked to a lower risk of heart disease. 

Aim for at least five portions a day - an adult portion is 80g or around a handful. Fresh, tinned and frozen fruit and veg count, as do pulses such as beans, peas and lentils.

2. Cut back on salt

Adults should eat less than 6g of salt a day, but UK intakes are closer to 8g a day. Eating too much salt causes water retention in your bloodstream which in turn increases your blood pressure. 

Sadly there's no such thing as 'healthy' salt. Sea salt, rock salt and pink Himalayan salt all have the same negative impact on your blood pressure. 

Our sense of taste can diminish as we age, causing people to reach for the salt shaker more frequently. So being aware of this, and using herbs and spices instead to pack in more flavour when cooking, is also worthwhile. 

However, there's lots of salt hidden in processed foods, such as bread, cereals, processed meat products (e.g. bacon, ham and sausages), dairy, snacks, sauces and spreads.

Look for foods with green and amber traffic lights for salt and try to avoid consuming too much of those with red traffic lights. 

3. Try to get enough sleep

Adults are meant to aim for around eight hours sleep each night but obviously the amount of sleep everyone needs is different. 

Shift work, regularly sleeping fewer than five hours a night and interrupted sleep or insomnia can cause high blood pressure.

Sleep problems are also linked to becoming overweight - this is believed to be caused by people eating more unhealthy foods if they're tired /busy, or having a drink to help them get to sleep.

Of course, this is all easier said than done if you have a job that requires anti-social or long hours, so don't stress too much about sleep, as it can be counter-productive. If you're struggling, see our tips for sleeping better for expert advice on how to get a good night's snooze.

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High Cholesterol - what you can do

1. Maintain a healthy weight

Bathroom scales

Being overweight increases your risk of heart disease. Research shows losing just five to ten percent of your body weight can have a positive impact on your blood pressure and cholesterol levels. 

But it's not only about how much you weigh, it's also about where you carry your weight. Being an 'apple' shape, where you carry weight around your middle can raise your cholesterol and also increase your risk of type 2 diabetes. This is because the fat sits around your organs (visceral fat). 

It's not always easy to lose weight and keep it off, but aiming to reduce the amount of sugary and fatty foods and swap in fruit, veg and pulses is a good start, along with reducing portion sizes. Ultimately, making smaller incremental swaps is likely to be more sustainable than trying a dramatic diet. See our guide to faddy diets to avoid and manageable diet tips.

2. Swap saturated fats for healthy fats

Olive oil and nuts

We need fat in our diet, but eating too much saturated fat can raise your cholesterol.

Swapping for foods with more unsaturated than saturated fats, such as olive oil and vegetable oil, will help keep your cholesterol down. 

Red and processed meats such as sausages also tend to be higher in saturated fat compared to poultry and fish, so cutting back on these can help too.

Lynne Garton, Dietetic Advisor for HEART UK, the cholesterol charity, says 'Unfortunately, there is still scepticism about the role of cholesterol and heart disease, but this goes against the totality of evidence which shows reducing saturated fat, and replacing with unsaturated fat, can help to lower cholesterol and improve overall heart health. 

This is the consensus of expert associations including the World Health Organisation, the UK’s Scientific Advisory Committee on Nutrition (SACN), the UK Health Security Agency (UKHSA) and the National Institute for Health and Care Excellence (NICE) and is based on randomised controlled trials, population studies and genetic studies.'

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3. Eat wholegrains and pulses 

These foods contain beneficial forms of fibre that help to lower cholesterol by preventing it from being absorbed into the bloodstream. Oats and barley contain beta glucan, and pulses (beans, lentils and peas) contain psyllium.

Adults are advised to eat 30g of fibre a day, but it's a neglected nutrient, with most people in the UK only managing around 18g.

Choosing wholemeal or seeded bread, high-fibre breakfast cereals, and aiming to add more pulses, fruit and veg to mealtimes will help you reach your fibre target. Including nuts and seeds in your diet will also help.

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4. Keep moving

Being active is beneficial for your heart - it can help you lose weight and keep your cholesterol and blood pressure in check - but it also has countless other benefits, lowering your risk of type 2 diabetes, stroke, several cancers. It can help your mental health and sleep too. 

The government recommends adults aim for at least 150 minutes of moderate intensity physical activity over a week - this is anything that raises your heart rate, makes you feel warmer and breathe faster but you not out of breath. 

Exercise doesn't have to mean pounding the streets on a run or going to a pricey gym class - it can include walking, cycling and swimming as well as dancing, tennis and even gardening.

Running, spin classes, weight lifting and other activities that cause you to breathe harder and leave you unable to hold a conversation are classed as vigorous activity. These are intense and can raise your blood pressure quickly and put extra strain on your heart.

If you already have high blood pressure and are new to exercise you should check with your doctor before undertaking vigorous exercise. It's best to start small and build up to more intense exercise.

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5. Cut the cigarettes

Smoking doubles your risk of heart attacks and stroke. so cutting back or stopping will benefit your heart health (and overall health).

Smoking damages the walls of your blood vessels, leading to cholesterol being deposited on artery walls and causes them to narrow. This means your heart has to work harder to move blood around your body.

It's never too late - the British Heart Foundation says that if you quit smoking your risk of a heart attack is half that of a smoker after one year. 

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Does wine really help your heart?

Red wine being poured into glass

Like any evidence that chocolate, caffeine or other treats are good for us, this is one persistent myth that we may want to believe! However, the theory that alcohol is good for your heart isn't strongly backed by the science.

When factors such as diet and exercise are adjusted for, any protective effects of alcohol disappear and overall the risks outweigh the benefits.

There is one exception: women over 50, for who a very low alcohol intake, less than one unit a day (equal to under half a glass of wine) appears to have some protective effect on the heart. 

But at levels more than one unit a day this protective effect disappears and there's an increased risk of heart disease.