Telomere shortening is a feature of cellular ageing common to a range of human tissues. Shorter telomeres are associated with an increased likelihood of mortality, including death from heart disease. We examined the association between telomere length and heart disease (present in 33%) in a well-characterised, narrow age cohort of older people (n=190, all born in 1921), and tested for any concomitant effects of medication use. Mean telomere length was significantly shorter in participants who reported heart disease (p=.001). Participants with ischemic changes on ECG had shorter telomere lengths (6.67 versus 7.65 kb, p=.021) after adjusting for other ECG abnormalities. This finding adds to the growing body of evidence for an association between telomere shortening and ischemic heart disease. Telomere shortening in peripheral blood leukocytes is a promising index of ischemic heart disease risk in older people and deserves further investigation as a potential mechanism.