For American Heart Month 2025, Senior Scope interviewed Dr. Michael Rocha, a cardiologist at Hawthorn Medical Center and Director of New Bedford Wellness Initiative, about heart disease and how people can remain healthy as they age.
Are there any specific risk factors people should be aware of based on their medical history or lifestyle?
Dr. Rocha: The major risks for heart disease include high blood pressure, high cholesterol, a family history of a heart attack in relatives in their 40s or 50s, obesity, diabetes, tobacco, inactivity, excessive alcohol intake(raises BP and triglyceride levels) and stress. Some of this list can be improved or managed through lifestyle, others may require medications at different stages.
What symptoms should people watch for that might indicate a serious heart issue?
Dr. Rocha: Two important symptoms to look out for include significant shortness of breath or chest discomfort in particular circumstances. Symptoms vary making it tricky and the context of these symptoms is very important.
If you are exercising to an extreme, some shortness of breath is expected and other factors that can contribute to increased shortness of breath are weight gain or inactivity. However, if people experience breathing issues on short distances such as a couple of blocks or a couple flights of stairs that are new, they should reach out to their doctor to discuss or make a visit. Breathing issues can be subtle for people with good physical reserves. Sometimes people express their shortness of breath as tiredness or fatigue with activity. Shortness of breath can be from many things including lung issues but if it is becoming a concern, always discuss with your doctor at a visit.
Some types of chest discomfort can indicate a heart attack or a narrowed heart artery. The description when heart related is most often a burning, pushing, pressure, tightness or squeezing sensation that feels deep and doesn’t change with movement or touching the spot. If it happens all of a sudden, it can indicate a heart attack especially if other symptoms such as the discomfort goes to the jaw and left arm and people are sweaty, nauseated and short of breath. If this is going on for 15 minutes, CALL 911.
Sometimes, an artery narrowing is in the moderate to severe range and people start with the above discomfort symptoms with more vigorous activity and then it goes away with rest in seconds to minutes. This is a supply and demand issue where, with more activity, the heart needs more blood and oxygen which it isn’t getting because of the narrowing. Sometimes these symptoms increase in severity or come on with less activity, this warrants a check up especially if this is new. Not all artery narrowings require a stent to open the artery and sometimes medicines can make a big difference depending on the circumstances. Keep in mind sometimes symptoms don’t fit the textbook including indigestion feelings not associated with foods or eating, so if in doubt, get checked out.
What tests or screenings should people undergo to assess heart health?
Dr. Rocha: It is important to know your numbers: blood pressure, cholesterol and fasting blood sugar. Ideally, we are looking for blood pressure on average to be 120/80 or below. Total cholesterol under 200 with an LDL below 130 for those at lower risk or below 100 for higher risk. Fasting blood sugar less than 100. These goals can be achieved through a combination of lifestyle and medications if appropriate.
Should people be concerned about arrhythmias?
Dr. Rocha: Heart rhythm can be very important but usually a doctor can often determine if it is regular at that time on examination by listening. If in doubt, a confirmatory EKG can help them. The challenge is that rhythm issues can come and go, making diagnosing them difficult if not present at the time of the examination.
We are living in a time where there are many wearable devices, including the Apple Watch or similar devices. Some of these are accurate but not always and many have different settings. Therefore, some normal findings can be overinterpreted by these devices and lead to anxiety. If there are alerts on the wearable device, it is worth reviewing them with your doctor. There have been times when an Apple Watch has picked up an arrhythmia such as atrial fibrillation which is a risk for stroke that may warrant further evaluation and treatment. At this point, we are not routinely recommending everyone get a wearable and use the information case by case. I do recommend some monitoring devices in certain settings.
Palpitations may indicate an arrhythmia and can vary in description including a fast heart, skipping, pounding, fluttering and several other sensations in the chest. These symptoms can at times indicate an abnormal rhythm but many times patients are sensitive to some early beats or a normal faster rate at times which we all have. However, if we are sensitive or paying more attention, we may notice.
Certainly, if palpitations are increasing or worrisome, there can be rhythm issues and letting your doctor know is the next step. If you have palpitations and are passing out, this is definitely something that requires evaluation to make sure that there is not a significant arrhythmia.
Importantly, stress can result in more input to the heart and lead to more early beats, a faster heart rate, or even some arrhythmias. The heart responds to the increase in adrenaline or stress hormones. Finding ways to manage stress and anxiety is very important to heart rhythm health.
What dietary changes should people make to improve heart health?
Dr. Rocha: The most studied diet for heart health is the Mediterranean DIet approach with a focus on vegetables, fruit, nuts, olive oil, fish, chicken and limiting red meat, dairy, sugar and processed foods. Gaples Institute has a great free learning module that I strongly recommend and is free. (Visit www.gaplesinstitute.org/nutrition_course/)
How much physical activity is recommended?
Dr. Rocha: Walk as much as you can is my number one overall tip for cardiovascular health here, but definitely do stretching, balance exercises and strengthening. Everything counts. 150 minutes a week is the current recommendation for moderate activity such as walking and it doesn’t have to be 10,000 steps a day. We don’t know the exact number of steps for everyone but more than 2,300 steps has been shown to have potential heart benefits and somewhere in the 4,000 to 10,000 steps has been shown to reduce the risk of death and death from cardiovascular disease based on recent studies over the past 4-5 years.
The exact number of steps based on age is different in each study, but it may be reasonable to have a goal for about 8000 steps a day for those less than 60 and lower for over 60. Join our Walk with a Doc Group, currently at the mall on Saturdays, 9 a.m., starting near the theater. We will be back at Buttonwood in April on Saturdays.
Are there specific lifestyle habits people should adopt or avoid to protect their heart?
Dr. Rocha: Continue to make attainable goals to reduce stress, sleep 7-8 hours, eat a Mediterranean diet, maintain strong social connections and get out and walk with us! We also welcome everyone to join our free wellness offerings on Sunday mornings at the Boys and Girls Club of New Bedford.
Happy Heart Month everyone!
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