Most American’s hearts may be older than their chronological age

Biological aging is hot. Even if scientists don’t agree on its definition, estimating how old your body is despite what the calendar says has gained steam in recent years. Measuring telomeres or genetic variables may be more appealing than, say, predicting your chances of having a heart attack as a percentage over 10 years, but under either method, age can move in two directions, adding years with exposure to unhealthy environments or subtracting them with both good luck and behaviors. 

By a new tool that assesses heart health using standard measures like blood pressure and cholesterol, most Americans are not aging well. Whether sharing that information as “heart age” will help them remains an open question. 

Cardiologists took advantage of the current zeitgeist in a JAMA Cardiology research letter published Wednesday in which they proposed a heart age calculator doctors can use to compute a patient’s cardiac future in a typical primary care visit. Age, sex, cholesterol, blood pressure, eGFR (a measure of kidney health), diabetes, smoking, and taking statins and high blood pressure medications are fed into a formula based on the PREVENT model, a set of equations released last year to inform treatment guidelines. An older risk calculator, out in 2008, was based on the well-established Framingham Heart Study. PREVENT uses more contemporary data reflecting a wider population.

“I think this is an interesting approach that will hopefully prove to be a good way to communicate about risk of cardiovascular disease that patients find meaningful and understandable,” Jeremy Sussman, a primary care physician at the VA Ann Arbor Healthcare System, told STAT. Sussman, also a health services researcher at the University of Michigan, was not involved in the JAMA Cardiology paper.  “We’ve developed many ways to communicate cardiovascular risk in the past and sometimes patients don’t find those as clear as we would like to hope.” 

When the new risk calculator was applied to 14,000 Americans in a long-running national health survey who were 30 to 79 years old, it said more than half of adults have hearts older than their chronological age, with wider gaps on average for some groups. For example:

• Women had a heart age of 55.4 compared to a chronological age of 51.3. For men, the average heart age was 56.7 compared to a chronological age of 49.7. 
• Having a high school education or less added 10 years to heart age.
• Black men’s heart age was 8.5 years older than their actual age; the gap was 7.9 years for Hispanic men, 6.7 years for Asian men, and 6.4 years for white men.
• Black women’s hearts were  6.2 years older, Hispanic women’s were 4.8 years older, white women’s 3.7 years older,  and Asian women’s were 2.8 years older.

“Things like heart age can be a little bit more motivation for diet and exercise changes, potentially smoking cessation, in addition to adherence to medication if it’s indicated,” co-author and preventive cardiologist Sadiya Khan told STAT. She is a professor of cardiovascular epidemiology at Northwestern University Feinberg School of Medicine. “We’re hoping that this allows a different way to communicate that resonates or allows people to connect with this idea of aging that I think is a little easier to understand than risk for having an event.” 

Khan said more research is needed on what the optimal strategy for risk communication might be.

“Ultimately, whether it’s your heart age or it’s your risk score, all of these are meant to help primary care clinicians and preventive clinicians improve cardiovascular health and prevent cardiovascular disease,” she said. 

In a companion editorial, physicians Mohammad Al Mouslmani, Abdulla Damluji, and Michael Nanna warned that knowledge could cut two ways.

“While a higher biological age may motivate some individuals to adopt healthier behaviors, others may find such information demoralizing or overwhelming, especially those with fewer resources or competing life demands,” they wrote. “Public health messaging and clinician communication should be sensitive to these dynamics, ensuring that risk age is framed not as a verdict, but as an opportunity for change, supported by accessible interventions.”

STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.