An online calculator for heart health

For decades, the Framingham Risk Score, which includes various health metrics, has been used to predict a person's 10-year likelihood of developing heart disease. In 2023, the American Heart Association released new equations to predict heart disease risk called Predicting Risk of Cardiovascular Disease Events (PREVENT). The PREVENT equations were developed using data from tens of thousands of U.S. adults, beginning at the age of 30.

In a new study published in JAMA Cardiology, researchers used PREVENT data to determine benchmarks for several indicators of optimal heart health among men and women at every age from 30 to 79. These markers included age, sex, cholesterol, blood pressure, eGFR (a measure of kidney health), diabetes, smoking, and taking statins and high blood pressure medications.

Using this data, the researchers created a new risk calculator and used it to check the heart health of 14,000 U.S. adults who were part of the National Health and Nutrition Examination Survey. According to the researchers, over half of the participants had hearts older than their chronological age, with certain groups having wider gaps.

For example, the average heart age for men was 56.7 years compared to a chronological age of 49.7 years. In comparison, women had a smaller gap between their average heart age and chronological age, which was 55.4 years and 51.3 years, respectively.

Black, Hispanic, and Asian men also had older heart age gaps than white men. Among women, black, Hispanic, and white women had older heart age gaps than Asian women. Black men, along with people who had a high school education or less, had the largest gaps between the heart ages and their chronological ages.

Commentary

According to Jeremy Sussman, a primary care physician at the VA Ann Arbor Healthcare System, the heart age calculator "is an interesting approach" and hopefully, it will "prove to be a good way to communicate about risk of cardiovascular disease that patients find meaningful and understandable."

Similarly, Martha Gulati, director of preventive cardiology and associate director of the Barbra Streisand Women's Heart Center at Cedars-Sinai Health Sciences University, said the heart age calculator is "a way to communicate risk that will resonate with some people."

However, Gulati noted that the calculator has limitations. For example, the equations don't account for certain cardiovascular risk factors that are specific to women, such as pregnancy complications or menopausal changes. They also don't include estimates of aerobic fitness or exercise habits, which can be crucial to heart health.

What to do if your heart's age is older than your chronological age

According to Sadiya Khan, a professor of cardiovascular epidemiology at the Northwestern University Feinberg School of Medicine and the study's senior author, it's important to have context around the difference between your heart's biological age and your chronological age.

"A year's difference from your chronological age is probably not meaningful," Khan said. "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."

If your heart age is at least five years older than your chronological age, Khan recommends talking to your doctor since the calculator may be suggesting that you could benefit from increased vigilance.

"We know that half of people with high blood pressure aren't being treated, and most people who qualify for statin therapy aren't on it," Khan said. "… Lifestyle changes, especially exercise and diet, are also important."

"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," Khan said. "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."