Key Takeaways

• Your cardiovascular age can differ from your actual age and may reveal hidden risks for heart disease, based on factors such as blood pressure, cholesterol levels, and lifestyle habits.
• An older heart age is linked to lower longevity and increased risk for cardiovascular disease.
• You can take steps to lower your heart age and improve your health.

 {{mid-cta}}

Cardiovascular (heart) disease (CVD) remains the leading cause of death globally and in the United States. For decades, researchers and clinicians have been working to identify the key factors that contribute to heart disease and to reduce its impact. You may be familiar with standard indicators of heart health, such as resting heart rate, blood pressure, and cholesterol levels. But have you ever heard of cardiovascular age? Knowing your heart age provides a powerful lens into your long-term health risks and offers an opportunity to take steps toward improving your heart health and supporting overall well-being.

Understanding Cardiovascular Age

As you age, the heart undergoes various changes that contribute to an increased risk of cardiovascular disease. These changes include thickening of the heart wall and increased stiffness of the valves between the heart's different chambers. Certain health and lifestyle factors can cause similar changes in the heart, and in many cases, can accelerate heart aging.

Cardiovascular age is a measure of heart health that can differ from your chronological age. There is no universally accepted method to calculate your heart age; however, various calculators have been developed (learn more in the next section) that assess your risk of heart disease based on factors such as blood pressure, cholesterol levels, and smoking status.

A younger heart has lower cardiovascular risk, and having a heart age that is older than your chronological age puts you at risk. Consider the difference between two 70-year-old men: one has high blood pressure and cholesterol and smokes cigarettes; the other has healthy blood pressure and cholesterol and does not smoke. The non-smoker has an older heart age, despite both men having the same chronological age. The CDC estimates that ¾ of Americans have a heart age that is older than their chronological age.¹

Measuring Your Heart’s Age

Several different methods have been used to measure or estimate heart age. Some are easier to measure than others:

• Pulse wave velocity (PWV): PWV measures how fast pressure waves move through your arteries. When your arteries are stiff (which is undesirable), the pulse wave moves more quickly. Arteries and blood vessels stiffen with age, but they may also stiffen in response to plaque deposits, often resulting from high cholesterol levels or smoking tobacco. Stiff arteries can reduce blood flow and increase blood pressure, leading to an increased risk of cardiovascular disease, stroke, kidney disease, and Alzheimer’s disease.^2-4 PWV can be measured using tonometry, ultrasound, or using blood pressure cuffs placed on different parts of the body.
• Carotid Intima-Media Thickness (CIMT): The thickness of the carotid artery can be directly measured as an indicator of overall heart health and age. This is done via ultrasound.
• Heart age calculators: The least invasive methods of estimating heart age are risk calculators. These calculators, including those developed by the American Heart Association and the American College of Cardiology, estimate cardiovascular risk based on various health and lifestyle factors, such as age, sex, race, cholesterol levels, blood pressure, diabetes status, and smoking history.

Factors Influencing Cardiovascular Age

What can you do to keep your heart healthy and young? Some of it may be out of your hands. Genetics play a major role in cardiovascular health. One study of almost 50,000 men in the United States found that a family history of cardiovascular disease increased the risk of CVD mortality by 44%.⁵

Despite this, you can still take charge of your health. Risk factors commonly included in heart age calculators include lifestyle factors like smoking as well as partially-modifiable factors like blood pressure, cholesterol, and diabetes, which may have a genetic component but can often be improved through lifestyle. Also included are treatments for high blood pressure or cholesterol (such as statins), which may reduce the risk of CVD.⁶ Importantly, lifestyle factors including diet, exercise, and stress management are not easy to quantify and are not often included in heart age calculators, but still play a major role in improving heart health and reducing risk.

Implications of an Older Heart Age

A cardiovascular age, or biological age, that exceeds your chronological age can put you at risk of heart disease and negatively impact your longevity.

The Framingham Heart Study was a long-term population-based cohort study that began in 1948 and aimed to identify risk factors of heart disease. Researchers enrolled more than 5,000 adults in Framingham, Massachusetts, who did not initially have cardiovascular disease and tracked them over time. One study using Framingham data wanted to learn the effects of heart disease risk factors, including high blood pressure, high cholesterol, glucose intolerance, smoking, and educational attainment, on survival to age 85.⁷ They found that, with no risk factors, 37% of men and 65% of women lived to be at least 85 years old. However, with all five risk factors, survival dropped to 2% for men and 14% for women.

In a separate study using the same sample, researchers found that after adjusting for factors including age, nearly two-thirds of cardiovascular disease events (including heart attack) could be attributed to high blood pressure or high cholesterol.⁸ While blood pressure and cholesterol are only part of the picture of heart age, these findings underscore the important role heart age plays in cardiovascular health outcomes.

Strategies to Improve Heart Health and Reduce Cardiovascular Age

While some risk factors (like race and gender) are non-modifiable - meaning, they aren’t things you can change - there is still a lot you can do to support heart health. Consider the following:

• Follow a heart-healthy diet: The Mediterranean Diet (MD), which emphasizes fruits, vegetables, whole grains, and lean proteins (all heart-healthy foods), is associated with a 30% reduction in cardiovascular disease risk.⁹ Don’t worry about following the diet to a T - even incorporating some components of the MD reduces your risk.
• Move your body: The Physical Activity Guidelines for Americans recommend 150 minutes of moderate-to-vigorous physical activity (heart rate zones 1-2) per day.¹⁰ In a cohort study that followed more than 10,000 adults in the U.S. for 25 years, men who met physical activity guidelines reduced their risk of cardiovascular disease by 13% and women decreased their risk by almost 30%.¹¹
• Consider other lifestyle changes: Quitting smoking, limiting alcohol consumption, reducing stress, and improving sleep are all related to maintaining good heart health.
• Go to the doctor: Heart disease is often silent, without noticeable symptoms. Regular health screenings, including blood pressure checks and lab work, enable the early detection of potential problems, allowing for prompt action.

Monitoring Progress and Staying Informed

It is essential to monitor your heart health and stay current with regular medical check-ups. For most adults, these will include measurement of blood pressure as well as blood work to assess cholesterol levels. For adults at risk of heart disease, regular EKGs may also be recommended to assess heart health.

Even outside of the doctor’s office, technology can help you track cardiovascular health at home. Heart rate monitors, whether a separate chest or wrist strap or a monitor built into your smartwatch, can help you stay on top of metrics like resting heart rate and heart rate variability. If you have hypertension, tracking your blood pressure with a portable blood pressure cuff can help support heart health.¹² If you need more data, numerous apps and products exist that allow you to record EKGs from your phone and share data with your healthcare provider in real time.

As always, consult with your doctor to determine the best type of monitoring for you.

The Bottom Line

Cardiovascular age offers a snapshot of how your heart is doing beneath the surface - and it might be older (or younger!) than you think. Even if you’re feeling fine day to day, an older heart age is linked to a higher risk of heart disease. The good news? Your heart age is not totally out of your control. Eating more whole foods, staying active, managing stress, and maintaining regular check-ups can all help keep your heart healthy and improve longevity.

Learn More With Signos’ Expert Advice

Blood sugar health seriously affects how you feel and how well your body functions. That’s why it’s so important to choose the right medication and make healthy choices to manage your blood sugar. Understanding the connections between medications, lifestyle choices, and blood sugar can give you the tools that you need to stay healthy.

A continuous glucose monitor (CGM) enables you to enhance your health by tracking your diet, exercise, sleep habits, and blood sugar levels. Knowledge is power, and a CGM can provide you with specific information about how your habits impact your health. 

Signos has a team of health experts who compile evidence-based nutrition information to help you improve your health and wellness. Check out the resources here.