3 Subtle Signs You May Need a Cardiovascular Checkup

3 Subtle Signs You May Need a Cardiovascular Checkup

Your body is sending you messages daily. Here are three you never want to ignore.

By Suzanne Steinbaum, DOUpdated February 1, 2022


Stress has a huge impact on our heart health. The behaviors we use to deal with life’s pressures, interrupted sleep and inflammation all play a role. The last few years have been extremely stressful thanks to isolation, fear and financial concerns caused by the COVID-19 pandemic, the constant threat of possible sickness, plus strife over cultural and political differences in our own families and communities.

As a preventive cardiologist, I worry that the stress of this one-two-three-four punch is going to have an impact on our hearts. A new study published in the journal Circulation observed that Americans’ blood pressure rose significantly in the past year. I have seen this exhibited in my patients along with symptoms such as heart palpitations, chest pain and an increase in unhealthy behavioral choices.

During the first months of quarantine, many people resorted to stress behaviors that were unhealthy, such as overeating (on average people saw a 29-pound weight gain during quarantine), drinking too much (alcohol sales increased exponentially) and being sedentary (hello, binge-watching culture). Making matters worse, people struggled to keep up with regular health checkups, including routine doctor visits and preventive testing, i.e., mammograms, colonoscopies and blood tests.

My goal is to help people protect their hearts before they develop cardiovascular disease, which, even in the face of COVID-19, is still the number one killer of both men and women in the U.S. If it were up to me, everyone would see a doctor for a full workup right now, including an electrocardiogram and other screenings, like heart-rate variability (the variations in time between each heartbeat) and testing of the endothelium (the thin membrane that lines the inside of the heart and blood vessels).

That’s not practical, or possible, for everyone so I’ll settle for this: In addition to scheduling an annual physical for yourself, take a few minutes to review this list of early-warning signs of an unhappy heart. If any one of these sound familiar, call your doctor and make an appointment sooner rather than later.

1. Your Go-To Workout Seems Harder Than Usual

I tell all my patients that exercise is good for you and it’s a barometer for your health. People who exercise regularly tend to know their bodies better than anyone else, so don’t ignore it if something feels off when you’re on the Bike, Tread or mat. Feeling sluggish during a class after sleeping poorly the night before isn’t a cause for alarm. Even struggling for two or three sessions when you’re not feeling great is generally nothing to worry about. When you’re stressed or you haven’t been fueling well with good nutrition and rest, you simply can’t push your body as hard.

However, exercise intolerance, which is a common sign of early heart disease, is different. Exercise intolerance means that you simply can't do the same amount of work, at the same level, as you would normally do. If you can no longer get through one of your favorite classes without feeling exhausted, it could be a sign that your heart is struggling more than it should. Needless to say, it’s time for a checkup.

2. Your Blood Pressure Is Rising

There’s a reason a medical assistant or nurse slaps a blood pressure cuff on you every time you show up for an appointment: High blood pressure is a serious matter. It puts increased pressure on the lining of your arteries and blood vessels, causing stiffness of the arteries and potential microtears that lead to plaque buildup.

Blood pressure is measured by two different numbers: Systolic and diastolic. You’ve probably heard those terms before. Systolic refers to the pressure in your arteries when your heart beats and pumps blood throughout the body, delivering oxygen. Diastolic is the pressure in your arteries between beats. Together, you want those numbers to be below 120/80.

Many people switched to telehealth appointments when the pandemic hit, so if you haven’t had an in-person medical appointment in a while—and therefore haven’t had a blood pressure screening—schedule an annual physical. Or, at the very least, test yourself using a blood pressure machine at a pharmacy.

If it turns out that your blood pressure is elevated, talk to your doctor about lifestyle changes and medication. Also, here’s where frequent exercise can help. Research shows 150 minutes of moderate cardio a week can decrease blood pressure. The catch: Consistency is key to lower blood pressure. If you stop working out, it can tick right back up.

3. Your Resting Heart Rate Increases

Your heart rate is a measure of how hard your heart is working to pump blood throughout your body. It changes depending on whether you’re relaxing in bed, standing, reading an unpleasant email from your boss or in the middle of a climb on your Bike. Resting heart rate (RHR) is the number of beats per minute when your body is truly at rest. To find out yours, measure it first thing in the morning when you’re still lying down. You can do it manually or by checking your Apple Watch or other wearable.

A normal RHR is between 60 to 100 beats per minute. In general, the stronger your heart, the lower your RHR. Some athletes have rates that hover closer to 40. An elevated RHR may be a signal that you’ve been neglecting your mental, emotional or physical health—and that your heart is paying for it.

If you’re like many Members in the Peloton community, you likely have a wearable on your wrist most, if not all, of the time. If so, take a moment to look back at your heart rate trends over the last few weeks or months. Does your RHR seem to be inching up? If so, that could mean that your cardiovascular health is trending down. Managing stress with meditation or yoga can help lower RHR, as can getting on the Bike or Tread more regularly. Your heart is a muscle like any other muscle in your body: It gets stronger with frequent conditioning!

Dr. Suzanne Steinbaum is a leader in preventive cardiology, now in private practice in New York, and is a paid consultant of the Peloton Health and Wellness Advisory Council. She is the CEO/Founder of Heart-Tech Health, a technology-based prevention model. She published Dr. Suzanne Steinbaum’s Heart Book: Every Woman’s Guide to a Heart Healthy Life, and has been a national spokesperson for Go Red through the American Heart Association for 18 years. Follow her on Instagram and Twitter.

The content [provided here] is for informational and educational purposes only and does not constitute individualized advice. It is not intended to replace professional medical evaluation, diagnosis, or treatment. Seek the advice of your physician for questions you may have regarding your health or a medical condition. If you are having a medical emergency, call your physician or 911 immediately.