Time is Muscle

Health Source

Your heart is your home. Like a house, it relies on two essential systems to function properly: an electrical system and a plumbing system. The electrical system controls your heart’s rhythm, while the plumbing system—your coronary arteries—supplies oxygen-rich blood to the heart muscle. When either system is compromised, the health of your heart is at risk.

What Is a Heart Attack?

Over time, the coronary arteries can develop plaque buildup, a condition called atherosclerosis. Plaque forms when the inner lining of the artery is damaged, allowing cholesterol and inflammatory cells to accumulate. As plaque slowly grows, it narrows the artery and restricts blood flow. This process often begins quietly, sometimes as early as our 20s, and can progress for decades without symptoms.

A heart attack occurs when one of these plaques suddenly ruptures. The rupture triggers a blood clot that can completely block the artery, cutting off blood supply to part of the heart. Without oxygen, that heart muscle begins to die—this is why clinicians say, “time is muscle.” The longer blood flow is interrupted, the greater the permanent damage.

Risk Factors That Matter

Several well-known risk factors damage artery walls and accelerate plaque buildup. High blood pressure, high cholesterol and smoking are among the most common. Diabetes and a family history of heart disease also significantly increase risk, particularly in communities where these conditions are more prevalent.

Knowing your numbers is one of the most important steps in prevention. For most people, recommended targets include blood pressure below 130/80, LDL (“bad”) cholesterol below 100 mg/dL (lower for those at very high risk), and for individuals with diabetes, a hemoglobin A1c below 7%.

Why Women’s Risk Is Different

For women, cardiovascular risk is more complex and often underrecognized. Pregnancy acts as a cardiovascular stress test; complications such as preeclampsia, gestational diabetes, preterm delivery or pregnancy-related hypertension can reveal early vascular dysfunction and increase long-term risk.

Menopause brings hormonal changes that may worsen cholesterol, blood pressure and body fat distribution, often accelerating risk in midlife. Chronic stress and caregiving demands can raise blood pressure, disrupt sleep and affect glucose control, while autoimmune and inflammatory diseases—more common in women—can accelerate blood vessel injury. These factors do not replace traditional risks; they add to them.

Steps to Protect Your Heart

The good news is that there is much you can do to protect your heart. The American Heart Association’s Life’s Essential 8 provides evidence-based guidance: eat a healthy diet, stay physically active, avoid tobacco, maintain a healthy weight, control blood pressure and cholesterol, manage blood sugar and prioritize quality sleep.

If you have a history of pregnancy complications or are approaching menopause, talk with your healthcare provider about earlier or more frequent screening and whether individualized strategies may be appropriate.

Symptoms You Should Never Ignore

Heart attack symptoms can vary, and when in doubt, seek care. Warning signs include chest pressure or heaviness, shortness of breath, nausea, or pain in the jaw, neck, back or shoulders—especially if symptoms are new, worsening or persistent.

Many women delay evaluation, attributing symptoms to stress, reflux or fatigue. Trust your instincts and call emergency services if something feels wrong. Early treatment saves heart muscle. Time is muscle.

Ellen Thompson, MD, is professor of cardiovascular services and director of the cardiology fellowship at the Marshall University Joan C. Edwards School of Medicine and director of noninvasive cardiology at Marshall Health Network – St. Mary’s Medical Center.