If I were sitting with you at a kitchen table, in a clinic room, or on a quiet afternoon walk, this is what I would want you to know. Heart readings are not grades, judgments, or reflections of how well you have lived your life. They are not a measure of effort or worth. They are another piece of information that helps tell a story about how your heart and blood vessels are doing right now and how you can best be supported moving forward.
We are talking about the measurements and tests that healthcare providers use to understand how the heart works day to day and over time. Many people hear regularly about blood pressure, heart rate and rhythm, cholesterol levels, echocardiograms (heart ultrasounds), and cardiovascular health scores, such as those used in Life’s Essential 8. While these numbers matter individually, they should not define you and should be viewed through a broader lens. They help reveal patterns and enable patients, caregivers, and healthcare teams to make thoughtful decisions that protect energy, independence, brain health, and quality of life.
Why Heart Readings Often Change With Age
Aging is not an illness. It is a natural process, and the heart ages along with the rest of the body. Many changes seen in heart readings are expected, even in people who have lived active, health-conscious lives. These changes help clinicians understand what is normal for aging and what may need monitoring or support. They are information, not failure. It is common as we age for:
- Blood vessels will gradually become less flexible
- Blood pressure to rise slowly
- Pulse pressure to widen
- The heart to pump slightly less forcefully at peak effort
- Heart rhythm to become mildly irregular at times
Understanding Blood Pressure and What the Numbers Mean
Blood pressure is one of the most common heart readings, and also one of the most misunderstood. Blood pressure measures how much force your blood puts against the walls of your arteries as your heart pumps. It is written as two numbers. The top number, called systolic pressure, measures the pressure when the heart contracts and pushes blood out. The bottom number, called diastolic pressure, measures the pressure in the arteries when the heart relaxes between beats.
In general, for most adults:
Normal blood pressure is less than 120 over 80.
Elevated blood pressure is 120 to 129 over less than 80.
High blood pressure begins at 130 over 80 or higher.
As people age, systolic blood pressure often rises. This happens because arteries become stiffer and less able to expand with each heartbeat. This does not automatically mean someone has done something wrong. It is a common and expected change with aging.
High blood pressure matters because, over time, it forces the heart to work harder and strains blood vessels throughout the body. Long-term, this can increase the risk of heart attack, stroke, kidney disease, and cognitive decline. This is why blood pressure management is such an important part of heart and brain health, even when someone feels well.
Understanding Pulse Pressure and What It Means When It Widens
Pulse pressure is a part of blood pressure that many people are never taught to understand, yet it provides important insight into cardiovascular health, especially in older adults. Pulse pressure is the difference between the top and bottom blood pressure numbers. For example, if your blood pressure is 130/80, your pulse pressure is 50.
In general:
A normal pulse pressure is about 30 to 50 mm Hg.
A pulse pressure consistently greater than 60 mm Hg is considered widened.
A pulse pressure below about 25 mm Hg may also indicate concern.
As we age, pulse pressure often widens, but this does not automatically mean something is wrong. Our large arteries naturally stiffen over time. Flexible arteries absorb some of the force when the heart pumps. Stiffer arteries do not. As a result, systolic pressure rises while diastolic pressure remains the same or decreases, creating a wider gap between the two numbers. However, research shows that it is associated with increased strain on the heart and blood vessels and a higher risk of cardiovascular events in older adults. This is why clinicians pay attention not only to the blood pressure reading itself, but also to the width of the pulse pressure, especially when tailoring treatment plans for aging adults.
Heart Rate and Rhythm
Rate refers to the number of times your heart beats per minute. Rhythm is whether the beats follow a steady, organized pattern. A normal resting heart rate ranges from 60 to 100 beats per minute for most adults. Many healthy adults, especially those who stay physically active, may have lower resting heart rates. Over time, occasional skipped beats, pauses, or brief irregular rhythms become more common. Many are harmless. Some, however, may signal conditions such as atrial fibrillation, medication side effects, or thyroid changes.
One of the most common tools for evaluating heart rate and rhythm is the electrocardiogram (EKG or ECG). This is a quick, painless test that uses small sensors placed on the skin to record the heart’s electrical activity. It can be either a one-time test in a healthcare office or a portable monitor (often called a Holter monitor) used over an extended period. The test shows how fast the heart is beating, whether the rhythm is regular, and whether there are signs of abnormal conduction, past heart injury, or strain on the heart muscle. Monitoring heart rate and rhythm is important because rhythm problems can increase the risk of fatigue, dizziness, falls, and stroke. Early detection allows for safer, more effective management.
Echocardiograms, Also Known as Heart Ultrasounds
An echocardiogram is a painless imaging test that uses sound waves to create pictures of the heart as it beats. It shows how large the heart chambers are, how well the valves open and close, and how effectively the heart pumps blood. Echocardiograms are often ordered when we experience symptoms, such as shortness of breath, swelling, chest discomfort, or irregular heartbeat. They may also be used to evaluate how aging or chronic conditions have affected heart structure and function. Echocardiograms provide critical information that cannot be captured by blood pressure or lab tests alone. They help guide safe, individualized care.
Why Cholesterol Matters
Cholesterol is not inherently bad. Your body needs it to build cells and produce hormones. The liver produces most of the cholesterol, and some comes from animal-based foods. Cholesterol travels through the bloodstream in particles called lipoproteins. HDL cholesterol helps remove excess cholesterol from the bloodstream and arteries and is protective. LDL cholesterol can build up in artery walls over time, forming plaque and increasing the risk of heart attack or stroke. Non-HDL cholesterol includes all types of cholesterol that contribute to plaque buildup and provides a clearer picture of risk. Managing cholesterol helps protect both heart and brain health, particularly in older adults.
AHA Life’s Essential 8
Life’s Essential 8 is a framework developed by the American Heart Association (AHA) that reflects the whole picture of cardiovascular wellbeing. It includes:
- Eating a balanced diet with fruits, vegetables, whole grains, lean proteins, and healthy fats.
- Staying physically active in ways that are safe and sustainable.
- Avoiding tobacco and vaping.
- Getting adequate sleep, ideally 7 to 9 hours per night.
- Maintaining a healthy weight.
- Managing cholesterol.
- Keeping blood sugar in a healthy range.
- Managing blood pressure.
These are areas where even small, steady improvements can meaningfully reduce risk and improve quality of life. Even modest improvements in one area can significantly reduce cardiovascular risk.
Remember
Heart readings, whether they come from a blood pressure cuff, a lab report, or a heart ultrasound, are guides. They translate what is happening inside the body into information that helps protect independence, safety, and quality of life.
The goal is not perfect numbers. The goal is to care for ourselves better through understanding, compassion, and steady progress. Gentle monitoring, supportive care, and small daily choices allow heart readings to become allies, helping you live well at every stage of life.