Have you ever stopped to consider how old you truly are at heart? Perhaps people have always told you that you have an old soul, or maybe as years have gone by, you’ve started to realize you’ll always feel young at heart. Regardless, if you truly want to know the answer, cardiovascular age calculators and new smart technology may provide you with a bit of insight.
Here’s what you need to know about cardiovascular age a.k.a. heart age, how this number is calculated, and what it can tell you about your overall wellbeing.
What is cardiovascular age?
“Basically the concept of cardiovascular age relates to the age of a person if all modifiable risk factors [for heart disease] are well-controlled,” Brian Downey M.D., director of general cardiology services at Tufts Medical Center tells Bicycling.
As you age, your arteries become stiffer and less elastic—this is what’s known as arterial stiffness and it is, to some extent, a natural part of aging; it can also be accelerated by uncontrolled risk factors, Downey explains. These risk factors include but aren't limited to smoking, obesity, high blood pressure, high cholesterol and physical inactivity, according to the Framingham study, a 76-year-old longitudinal study dedicated to uncovering characteristics of heart disease by observing multiple generations since its conception in 1948.
While it’s easy to notice changes in your physical appearance as you get older, it’s not as easy to notice what’s happening internally with age. Your cardiovascular age can help you understand how your internal health is changing overtime.
How is cardiovascular age determined?
Pulse wave velocity is the golden standard for measuring arterial stiffness—one of those key factors that determines cardiovascular health—and is one way to determine heart age, Edward Lakatta, senior investigator at the National Institute on Aging (NIA), a part of the National Institutes of Health (NIH) tells Bicycling.
Typically determined by monitoring and measuring the speed at which pulse waves, caused by heartbeats, travel from the carotid artery (located in the neck) to the femoral artery (in the leg), pulse wave velocity can also be measured at the fingertips, says Lakatta. This way of measuring pulse waves has become more common in large research studies, and can be less exact depending on what you need it for, he adds.
Smart devices, like Oura ring and the Withings smart scale, use pulse wave velocity technology to estimate heart age. This is how these devices help users better understand their risk for heart disease.
Another way to estimate heart age: The Framingham risk function, an algorithm developed using data from the multigenerational study. This function is commonly used by doctors, and is even available to patients through various websites, says Downey. For example, you can estimate your heart age with an online calculator like the one offered by the Heart Foundation of Australia. (Just have your blood pressure and cholesterol stats handy for more accurate feedback!)
What can your cardiovascular age tell you about your overall health?
“Cardiovascular age estimated by Framingham risk score or any of the other validated risk scores can certainly be a good indicator of a healthy cardiovascular lifestyle and is one part of an overall healthy life,” says Downey.
In terms of understanding your results and what cardiovascular age means for your health and lifespan, it’s important to know the difference between classifications for heart age.
Early Cardiovascular Aging
Early aging refers to those who appear to have the heart age of someone who’s older than their biological age, says Downey. “This typically occurs in patients who have had suboptimal control of multiple risk factors or risky heart behaviors throughout life,” he explains.
People with chronic inflammatory conditions (like HIV, lupus, rheumatoid arthritis, etc.), certain high-risk ethnicities (some South Asian populations, for example), or a rare genetic condition that can cause high levels of low-density lipoprotein a.k.a. bad cholesterol are at risk for early vascular aging.
Lifestyle choices such as smoking, excessive alcohol use or recreational drug use, and physical inactivity, also play a role in early aging, Downey says.
Normal Cardiovascular Age
Normal heart age refers to someone who is physiologically and biologically at their expected heart age for that time of life, says Downey. This means your cardiovascular system is aging appropriately based on the metrics measured, like the stiffness of your arteries (which smart devices can measure via that pulse wave velocity), or modifiable risk factors such as smoking and blood pressure.
Young Cardiovascular Age
A heart age younger than a chronological age is what’s known as a “supranormal heart age” a.k.a. super nova or supranormal vascular aging, Downey says. “This largely occurs in patients who have had healthy lifestyles and minimal or zero modifiable risk factors throughout their life,” he explains.
This is how researchers typically categorize different heart ages, however, it’s important to bear in mind that various online calculators and smart devices have their own categories. For example, Oura ring will indicate if your heart age is lower than, aligned with, or higher than your actual age. Withings determines if your heart age is optimal, normal, or not optimal.
Are there downfalls to cardiovascular age calculations?
Unfortunately, not every online calculator or smart device will give you the same heart age. “The age result completely depends on the algorithm behind the calculation, so the same person can get a younger age on one tool but an older age on another tool,” says Carissa Bonner, Ph.D., associate professor and behavioral scientist at the University of Sydney, and author of a study published in the Health Promotion Journal of Australia that examined the usefulness of calculators like those that estimate cardiovascular age.
In that study, Bonner and her colleagues tested 20 different age calculators (11 of which calculated heart age) using one 65-year-old profile, and found the age calculators offered varying results for the same profile. Biological age—which factors in bone age, fertility age, lung age, and kidney age—varied from older to younger in terms of deviations, while heart age was always calculated as older.
This is proof that not all calculators are designed the same, nor do they yield the same (or accurate) results. If you’re going to track your heart age, it’s best to find one way to measure it and stick with it to avoid confusion.
Also, you may want to turn to another, potentially better indicator of your overall health—that is, your maximum oxygen consumption. Also known as your VO2 max or cardio fitness, this is the measurement of the maximum volume of oxygen your body can take in during intense aerobic exercise, says Lakatta. VO2 max relates to a lot of functions in your body, but particularly your heart’s ability to pump blood, your tissues ability to extract oxygen from the blood, and also your lung capacity, he explains.
Research has linked higher levels of VO2 max to a longer life and lowered risk of diseases, including cancer, indicating how well it can predict your overall health. What’s more: VO2 max is a good way to measure your fitness progress overtime, as well as how you compare to other cyclists based on your age and experience level.
How often should you check your cardiovascular age?
Downey recommends checking your heart age at least once a year, regardless of if you have been diagnosed with cardiovascular disease or not. (Bonus points if you talk to your doctor about it, instead of just doing online calculations.)
Also, if you’re concerned about your cardiovascular health, particularly your risk for cardiovascular disease or stroke, then you’ll want to pay attention to your blood pressure, heart size (to ensure it’s not enlarged), and heart rhythm to make sure it’s not working too hard, explains Lakatta. Your primary care doctor should monitor all of these factors, depending on your health and age, he adds.
How can you improve your cardiovascular age?
While age calculators are meant to motivate you to change your lifestyle in the event that you’re at risk for cardiovascular disease, there isn’t a good amount of evidence to suggest that they can make people change their lifestyle behaviors unless they get additional support, Bonner says.
If you’re interested in improving your cardiovascular health on your own, though, Downey recommends starting with a healthy diet, exercising regularly, maintaining a healthy bodyweight, undergoing routine screenings for blood pressure, diabetes, and cholesterol, as well as avoiding smoking and other risky behaviors like alcohol and drug use.
Monique LeBrun joined the editorial staff in October 2021 as the associate health and fitness editor. She has a master’s degree in journalism and has previously worked for ABC news and Scholastic. She is an avid runner who loves spending time outside.
