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Is your heart older than you are?

A free, newly developed online calculator may be able to tell you, according to a large-scale study of heart health published Wednesday in JAMA Cardiology. Based on the most current equations about risks for cardiovascular disease, the calculator uses answers to a few simple questions about blood pressure, cholesterol status and other common measures of health, to determine your heart’s biological age, which can be different from your body’s chronological or calendar age.

Your heart could turn out to be biologically older, younger, or the same as your actual age, with differing consequences for your risks of developing heart disease.

“With the growing awareness of biological age being a different concept than chronological age, or how many times you’ve been around the sun, we wanted to find a way to apply that idea and help people better understand their particular risks” for developing cardiovascular disease, said Sadiya Khan, a professor of cardiovascular epidemiology at Northwestern University Feinberg School of Medicine and senior author of the new study.

The calculator is at the vanguard of “organ ageing” tests, which use a variety of advanced techniques and algorithms to determine whether certain parts of our bodies are ageing faster or slower than others. Most of these tests are still in early development. The heart-age calculator is one of the first to be widely available and free.

New ways of assessing heart health

The idea of using health data to assess your risk of developing heart disease is hardly new, of course. The Framingham Risk Score, which uses various health metrics to predict your 10-year likelihood of developing heart disease, has been around for decades. More recently, the American Heart Association developed the Predicting Risk of Cardiovascular Disease Events (Prevent) equations, which use new data about the health of tens of thousands of American adults, beginning at age 30, to predict heart disease risk.

Khan was the lead author of the 2023 study that laid out the Prevent equations.

But she’s also a clinician and knew from talking to patients that “it’s really hard to understand what a 10% risk” of developing heart disease in the near future “means for you”.

And she’s a researcher who’s studied longevity among the Amish and was interested in the differences between biological and chronological age, and why people born in the same year can seem to age quite differently.

Those interests converged when she began wondering if she could reinterpret the Prevent equations into a framework that would be more intuitive for most people, telling them, in effect, if their hearts are ageing too fast.

The study found most Americans have hearts older than their chronological age, with men averaging seven years older. Photo / 123rf

Most Americans’ hearts are older than they are

So, she and her colleagues used the Prevent data to figure out benchmarks for optimal heart health markers, such as blood pressure and blood sugar, among men and women at every age from 30 to 79. These would set the underpinnings of the heart-age test. (Most of the metrics used in the calculator are standard, but some are more specialised, such as an eGFR, which tests kidney function.)

Then, since they were interested in the state of heart health in America, they checked the heart ages of more than 14,000 men and women enrolled in the Government’s huge and ongoing National Health and Nutrition Examination Survey.

Most of them turned out to have hearts older than their biological age. Men, on average, had heart ages about seven years older than their chronological age, while women’s hearts were about four years older than their birth years. The gulfs between actual and biological heart ages were largest among people, especially men, with a high school education or less and those who identified as black or Hispanic.

But even many people in their 30s had relatively old hearts.

What to do about an ageing heart

What does it mean if the calculator says your heart is older than you?

“First, it’s important to have context,” Khan said. “A year’s difference from your chronological age is probably not meaningful. But if people’s hearts are more than five years or 10 years away from their chronological age, it’s worth paying attention to what’s going on and what might be driving that.”

Talk to your doctor if your heart age is at least five years older than your calendar age, she said. The calculator might be indicating you’d benefit from more vigilance. “We know that half of people with high blood pressure aren’t being treated,” she said, “and most people who qualify for statin therapy aren’t on it.”

The interventions needn’t all be medical. “Lifestyle changes, especially exercise and diet, are also important,” she said.

Even people whose heart ages equal or prove younger than their actual age can benefit from that knowledge, she said. “One of the most challenging things is to maintain healthy ageing.” So, as the years pass or you enter health transitions, such as menopause, the calculator might be able to help you track how well your heart continues to age.

The study suggests that if your heart age is over five years older, consult a doctor and consider lifestyle changes.

What the calculator leaves out

The heart-age calculator has limits, though. “It’s a way to communicate risk that will resonate with some people,” said Martha Gulati, the director of preventive cardiology and associate director of the Barbra Streisand Women’s Heart Centre at Cedars-Sinai Health Sciences University in Los Angeles.

But its equations don’t include certain cardiovascular risk factors specific to women, she said, such as menopausal changes and pregnancy complications.

They also don’t include estimations of aerobic fitness or exercise habits, which can be key to heart health, said Ulrik Wisloff, the head of the cardiac exercise research group at the Norwegian University of Science and Technology in Trondheim, Norway, who’s studied exercise and longevity for decades. “I still find it puzzling why physical activity and peak oxygen uptake have yet to be incorporated into the original Framingham risk model, despite strong evidence” for their predictive power, he said. His group has developed its own free, online calculator, based on exercise and endurance, that estimates your fitness age in comparison with your chronological age.

The key point about all of these biological-age calculators, whether they focus on fitness or organs, such as hearts, is that they can serve as a wake-up call, Gulati said. If the numbers indicate your heart might be ageing too rapidly, that’s a message that you probably need to be paying some more attention to your health.

“I do think” the heart-age calculator “is a bit gimmicky,” Gulati said. “But if it helps to motivate a patient to make changes, I’m here for it.”