How can we care for older parents' heart and blood vessels?

To look after older parents' heart and blood vessels, families can help through everyday habits: moving every day, including activities for balance and strength, less salt, no smoking, little or no alcohol, and regular check-ups to have their blood pressure measured, even when they feel well. It also helps everyone in the family to know the urgent signs, such as sudden severe chest pain, severe breathlessness or sudden weakness on one side of the body, and to call 1669 straight away.

How do the heart and blood vessels change as parents get older?

The US National Institute on Aging (NIA) describes several changes that come with age. Knowing them helps families tell everyday changes from signs that need a doctor.

The heart works differently under effort

The NIA explains that with age the heart cannot beat as fast during physical activity or stress, while the resting heart rate does not change much.

Occasional skipped beats

The NIA says occasional extra or skipped heartbeats happen more often with age and are not dangerous. A feeling that the heart is fluttering or racing that happens often or keeps going is different: it is a reason to see a doctor.

Problems may give no noticeable signs at first

The NIA notes that problems with the heart and blood vessels may give no noticeable signs at first, which is why regular check-ups with a doctor are important. Even when your parents feel well, it is still worth going for check-ups.

How much should older parents move?

WHO's 2020 guidelines include specific advice for adults aged 65 and over, adding balance and strength activities to the amounts for younger adults. The examples in the table are everyday ideas, not part of the guidelines.

Start where they are

WHO says older adults should be as physically active as their abilities allow, and adjust the effort to their fitness. The NIA adds that any physical activity is better than none, and advises talking with a doctor about the types of activity that suit each person. If your parents have not exercised for a long time, start with short walks and add a few minutes each week.

Make it something you do together

A morning walk in the park before it gets hot, walking to the market instead of driving, or a regular tai chi or dance group gives activity a fixed place in the week. Walking together also lets you see how easily your parents manage stairs or slopes.

For older parents' everyday meals and movement, see My older parents often feel unwell. What can we do each day?

What should we look at in their meals?

The NIA's advice for the heart is to eat plenty of fruit, vegetables, lean protein and foods high in fibre, such as those made with whole grains, and to choose foods low in saturated fat, added sugar and salt.

Salt matters more with age

The NIA notes that our bodies become more sensitive to salt as we get older. The UK's NHS advises adults to have no more than 6 g of salt a day, around 1 level teaspoon, including the salt already in food and the salt added during and after cooking. It notes that around three quarters of the salt we eat comes from packaged and everyday foods, such as meat products and ready meals, and that salt is also found in takeaway and restaurant meals.

Small changes in Thai meals

• Taste before adding fish sauce, soy sauce or seasoning powder, and keep the bottle off the table.
• Leave some of the broth in noodle soups and curries.
• Choose grilled, steamed or boiled dishes more often than fried ones.
• Swap some white rice for brown rice, and add a vegetable dish to rice-and-one-dish meals.
• Keep sausages, moo yor (Thai pork sausage), dried and salted fish and crisps as occasional foods rather than daily ones.

If your parents feel food tastes bland, flavour it with lime, herbs, garlic, chilli or pepper rather than extra salt.

For cutting back on salt in Thai food, see Love salty food and can't cut back? What can you do?

What other everyday habits matter?

Beyond activity and food, the NIA lists several habits for looking after the heart as we age.

Stop smoking, at any age

The NIA says quitting smoking, even in later life, can improve your health. If one of your parents smokes, offer support rather than criticism, and ask their doctor or a pharmacist about help to quit.

Little or no alcohol

The NIA advises not drinking much or any alcohol, and notes that as we age, alcohol can make existing health problems worse and interact dangerously with some medicines.

Stress and sleep

The NIA suggests learning ways to manage stress and relax, and talking about concerns with friends or family, as well as getting enough good-quality sleep. Talk with a doctor if your parents have difficulty sleeping.

Why check blood pressure even when they feel well?

The NIA advises having blood pressure and cholesterol checked regularly as you get older, even if you are healthy. The NHS lists being aged 40 or over as one reason it is particularly important to have blood pressure checked. How often your parents need checks is a question for their doctor; in Thailand, ask at your parents' hospital, clinic or a pharmacy.

Check-ups

• Go to check-ups as the doctor advises, and keep the results together so the doctor can see changes over time.
• Bring a list of every medicine your parents take, including vitamins and herbal products. Keep taking regular medicines as prescribed, and do not change or stop them without asking the doctor.
• Ask the doctor which tests your parents need at their age and how often.

Measuring at home

Measure at home if the doctor or nurse asks for it. The NHS describes how: take a reading, note the numbers, wait 1 minute and take another, usually twice a day, once in the morning and once in the evening. Take the record to the next appointment rather than reading meaning into single numbers.

Which signs mean we should go to hospital or call 1669?

Some signs cannot wait for an appointment. In Thailand, the National Institute for Emergency Medicine's number for medical emergencies is 1669.

Warning signs listed by the NIA

The NIA advises calling for emergency help if any of these come on suddenly or without exertion, and not to assume chest discomfort is something minor:

• crushing pain or pressure in the centre or left side of the chest
• pain, numbness or tingling in the shoulders, arms, neck, jaw or back
• shortness of breath when active, at rest or while lying flat
• fainting, light-headedness or sudden dizziness
• a rapid or irregular heartbeat
• cold sweats, or nausea and vomiting

Put 1669 in your parents' phones, and keep a list of their medicines and their doctor's details somewhere easy to find.