What I've learned about keeping my heart healthy after 60

My grandfather died of a heart attack at 54. My father suffered a devastating stroke in his sleep. He woke up completely blind and with no short-term memory. He is still alive, but his world changed overnight, without warning, in ways none of us could have anticipated.

I think about this more than I probably would if it hadn't happened in my own family. It gives the statistics a different quality, less abstract, more personal. When I read that heart disease kills more people in the UK every year than the entire population of Oxford, I don't find it a surprising number. I find it an entirely believable one.

Around a third of those deaths are in people under 75. And approximately 70 per cent of all heart disease cases are caused by modifiable factors, things that could be prevented or reduced with lifestyle changes, medication, or both. That last figure is the one worth sitting with. Seventy per cent. Not bad luck, not purely genetics. Choices and habits, things that can at least partially be changed.

I can't change what happened to my grandfather or my father. I can pay attention to what the evidence says, try to act on most of it, and be honest about where I fall short. What follows is my layman's summary, not a medical document, just the things that have stuck after years of reading about this for reasons that feel, to me, fairly personal.

Before I start: I'm not a medical professional and nothing here is medical advice. If you have concerns about your heart health, speak to your GP. The single most useful thing I can tell you is in point seven. Go and get your numbers checked. Everything else flows from knowing where you actually stand.

The things worth knowing

1. Fats: it's the type, not the total

You don't need a fat-free diet to protect your heart. That's old thinking and largely discredited now. What matters is the type of fat. Saturated fats, the ones predominantly in red meat, full-fat dairy, butter and processed meat, raise LDL cholesterol, the kind that contributes to arterial narrowing. Unsaturated fats, olive oil, oily fish, avocados, nuts and seeds, do the opposite. The Mediterranean diet, which I follow reasonably closely, is built around this distinction. It's not about eating less fat; it's about eating better fat.

My version: olive oil is the default cooking fat. Oily fish twice a week. Nuts daily. Red meat once a week at most, and not processed meat as a regular habit.

2. Purple food and porridge oats are quietly doing a lot of work

Two specific things I came across that have genuinely changed what I eat. Purple foods, blueberries, black grapes, aubergines, red cabbage, are associated with raising HDL cholesterol, the good kind that helps clear the bad kind from your arteries. And porridge oats contain soluble fibre that actively helps your body clear out triglycerides, a type of blood fat that's bad for heart health. Neither of these requires any particular effort to include; they just need to be on the shopping list.

My version: porridge most mornings with blueberries and a spoon of seeds. Aubergine appears in a lot of the Mediterranean dishes I cook anyway. Grapes as an evening snack more often than I used to.

3. Portion size matters, especially carbohydrates

A useful rule of thumb I've found myself applying: you don't need more carbohydrate in a meal than you can fit in your cupped hand. We're conditioned to fill plates, huge bowls of pasta, generous portions of rice, and the blood sugar spikes that result from consistently large carbohydrate portions have real long-term consequences for heart health. This isn't about eliminating carbs; it's about right-sizing them and making sure they're wholegrain where possible, which slows the blood sugar response considerably.

My version: I shifted from white to wholemeal pasta and rice years ago and bake my own wholemeal bread. The portion discipline is more of a work in progress, honestly.

4. Cardio matters as much as strength, possibly more for your heart

I do both, which I think is the right answer, but if I'm being honest about which one matters most specifically for heart health, it's the cardio. Muscle bulk and strength training are genuinely valuable, particularly for preventing the muscle loss that accelerates after 60. But the heart is a muscle too, and it needs its own specific kind of work: sustained elevated heart rate, the kind you get from running, cycling, swimming or brisk walking. The NHS recommendation is at least 30 minutes of moderate intensity exercise, out of breath but still able to speak, at least three times a week. That's the minimum. I run three times a week and do rowing machine intervals twice a week; between them they cover this reasonably well.

My version: the Couch to 5K story is on this site. Starting running at 57 was the single best thing I did for my cardiovascular health. I was a deeply unlikely candidate for it.

5. Sitting down all day is as bad as a poor diet

Research consistently shows that prolonged sitting is an independent risk factor for heart disease, meaning it causes harm even in people who exercise regularly. The mechanism isn't fully understood but the data is fairly clear: long unbroken periods of sitting slow circulation, affect blood sugar regulation, and are associated with worse cardiovascular outcomes regardless of what else you do. The fix isn't complicated: get up regularly, walk when you can, don't spend eight consecutive hours in a chair. I walk the dog most days for about an hour, which I now think of as health maintenance as much as dog maintenance.

My version: the dog walk is non-negotiable. On days I'm sitting at a computer I set a rough reminder to move every hour or so. Not perfect, but better than nothing.

6. Alcohol: the 14 units is not a target

The NHS guidance of 14 units per week is a limit, not a goal. This distinction matters because the framing of "up to 14 units" can make 13 units feel like responsible drinking, when the cardiologist's honest view is that the safest level is zero, and that every unit above a moderate amount is adding meaningful risk. Alcohol raises blood pressure temporarily, strains the heart, and adds empty calories that contribute to the weight gain that is itself a heart risk. The Mediterranean diet's "wine in moderation" framing has shifted in recent years. The 2025 version of the dietary guidelines moves alcohol explicitly into a "the less the better" category. I drink wine most evenings and I note this without pretending it's a neutral habit.

My version: I'm aware this is the area where my practice and my knowledge are furthest apart. Alcohol-free days, not binge drinking, and not pretending the evidence says something it doesn't.

7. Get your blood pressure and cholesterol checked. You cannot feel either

This is the one I'd underline twice. High blood pressure and high cholesterol have no symptoms. You cannot tell from how you feel whether yours are in a healthy range. Most people don't know their numbers, and not knowing doesn't mean the numbers are fine. Both conditions are treatable, sometimes with lifestyle changes alone, sometimes with medication, but only if you know about them. You can get checked free at many pharmacies, or ask your GP. A home blood pressure monitor costs around £30 and is, in my view, one of the more useful £30 spends available to anyone over 50.

My version: I know my blood pressure and get it checked regularly. Knowing the number, rather than assuming everything is fine, is the whole point.

8. A belly is a warning sign worth taking seriously

Men tend to store excess fat around their internal organs first, visceral fat, it's called, before it becomes visible as a belly. By the time the belly is noticeable, there's already a meaningful amount of fat around the organs, which is associated with significantly elevated heart disease risk. This isn't about appearance or weight in the conventional sense; it's about a specific type of fat storage that's particularly harmful and particularly common in men in midlife and beyond. The causes are the usual suspects: too many calories, not enough movement, and alcohol, which is a notably efficient way to accumulate abdominal fat.

My version: waist measurement is a more useful indicator than weight or BMI for this specific risk. Worth knowing yours.

The honest summary

I started paying attention to this because of my grandfather and my father. I keep paying attention because the evidence suggests it's worth paying attention to, and because 70 per cent preventable is, when you've seen what the alternative looks like up close, a genuinely motivating statistic.

None of this is new information. Most of it, in broad outline, is what a GP would tell you if you asked. The gap isn't knowledge. It's the distance between knowing something and actually doing it, which turns out to be where most of the difficulty lives.

What I've found useful is not trying to do everything at once, but finding the changes that fit naturally into a life I actually want to live. Running fits. The Mediterranean diet fits. I enjoy cooking and the food is genuinely good. The daily walk fits because we have a dog. Knowing my blood pressure fits because it takes five minutes and the information is worth having.

The alcohol is the honest gap. The portion sizes are a work in progress. That's the real picture, and I think the real picture is more useful than the version where everything is going perfectly.

My grandfather didn't get to 65. My father is still alive, but his later years have been shaped by something that happened while he slept, without warning, without any chance to prepare. I'm aware, more than most people perhaps, that this stuff isn't theoretical. That awareness is, I think, worth something, even if it doesn't make the glass of wine any easier to put down.