Heart Age Tops Actual Age in United States, CDC Says

Robert Lowes

September 01, 2015

A new and simpler way to express a person's risk for a heart attack or stroke still shows the nation to be heart unhealthy on average, but this metric may provide more motivation for patients to adopt healthier lifestyles, the Centers for Disease Control and Prevention (CDC) said today.

The metric is heart age, defined as the predicted age of a person's vascular system based on their cardiovascular risk factor profile, according to a study published online September 1 in the most recent issue of the Morbidity and Mortality Weekly Report. The CDC derived heart age for roughly 236,000 men and 342,000 women aged 30 to 74 years from their individual Framingham Risk Score (FRS), which estimates the odds of developing cardiovascular disease in the next 10 years. A predicted heart age that tops a person's chronological age indicates a greater risk, whereas a heart age younger than chronological age indicates the opposite.

The study found that predicted heart age exceeds chronological age on average by 7.8 years for men and 5.4 years for women. Only 30% of Americans had heart ages equal to or below their chronological age.

In a news conference today, CDC Director Thomas Frieden, MD, MPH, said the good news amid all these glum statistics is that heart age is a more graspable expression of cardiovascular peril than the likes of the FRS. It is therefore more likely to motivate Americans to stop smoking, exercise regularly, control their cholesterol and blood pressure, and adopt healthier lifestyles in general.

"The heart age is an understandable, simple tool that helps people take more control over their health," said Dr Frieden. "It's never too late to turn back the clock on your heart age."

Recognizing the need to sharpen its patient education, the Framingham Heart Study introduced the heart-age metric in 2008. The web site for the project features a calculator that asks for a person's sex, age, systolic blood pressure, body mass index, and whether he or she smokes, has diabetes, or receives treatment for hypertension. The calculator then determines a heart age and converts it into the individual's 10-year risk for cardiovascular disease, expressed as a percentage. Also shown are both the normal and optimal 10-year risk.

A reporter at the news conference asked Dr Frieden whether the heart age metric was too simple to be taken seriously. In response, Dr Frieden pointed to a recent study published in the European Journal of Preventive Cardiology that proved the motivational power of heart age. In the study, a control group received standard medical advice about cardiovascular disease, another group of subjects was given its 10-year FRS, and a third group calculated their heart age. Afterward, the FRS and heart-age groups significantly lowered their risk for a heart attack or stroke through lifestyle changes compared with the control group. The group that knew its heart age, however, improved the most.

Wide Racial and Regional Disparities

In addition to showing that most Americans are younger than their hearts, the study identified significant disparities in heart age when the numbers were broken down by race and ethnicity, region, and other sociodemographic factors.

For example, among men, blacks posted the highest heart age (58.7 years), ahead of Hispanics (55.7 years), whites (55.3 years), and others (54.7). Heart ages for women followed a similar pattern in terms of race and ethnicity.

Excess heart age, or the difference between predicted heart age and chronological age, decreased in inverse proportion to household income and education.

Heart age also varied dramatically depending on where a person lived.

The most advanced heart ages, by and large, were found in the South, whereas the lowest were in Northeastern and Western states.

Table 1. Healthiest Hearts by State

State Mean Excess Heart Age
Utah 4.3
Colorado 4.6
Massachusetts 5.1
Vermont 5.2
California 5.2
Hawaii 5.2

Source: CDC

Table 2. Unhealthiest Hearts by State

State Mean Excess Heart Age
Mississippi 9.6
Louisiana 9.1
Alabama 8.9
West Virginia 8.9
Arkansas 8.7
Kentucky 8.5

Source: CDC

Morb Mortal Wkly Rep. Published online September 1, 2015. Full text