Ahead of World Heart Day (September 29), cardiologists explain what can make your heart age faster, from high blood pressure and cholesterol to diabetes, smoking, stress and poor sleep.
You know your age, but do you know your heart age? The two numbers do not necessarily have to match.
Your cardiovascular risk can be influenced by years of high blood pressure, high cholesterol, diabetes, smoking, excess weight, physical inactivity, poor diet, stress and inadequate sleep. Some of these factors can begin affecting the heart and blood vessels long before a person develops any obvious symptoms.
“Cardiovascular age being referred to as ‘faster ageing’ means the consequences of different risk factors for heart diseases, which make people suffer from a heart attack, stroke or heart failure sooner,” explains Dr Chirag D, Consultant, Interventional Cardiology, Aster Whitefield Hospital.
He also stresses that “heart age” should not be interpreted as the literal age of an individual’s heart. It is a way of communicating cardiovascular risk.
Cardiovascular disease often develops silently over years. The World Heart Federation lists high blood pressure, high cholesterol, diabetes, tobacco use, obesity, physical inactivity, unhealthy diet, harmful alcohol use, stress and air pollution among the factors that can contribute to cardiovascular disease. Family history and age are among the risk factors that cannot be changed.
High blood pressure can quietly damage the heart
One of the biggest concerns is hypertension because it can exist without noticeable symptoms.
“High blood pressure is a good example. It may not cause obvious symptoms, but if left uncontrolled for many years, it can increase the risk of heart attack, stroke and heart failure,” says Dr Anjan Siotia, Director of Cardiology at BM Birla Heart Hospital, Kolkata.
The World Heart Federation describes hypertension as the world’s number one risk factor for death and notes that it often remains undetected because it does not necessarily produce symptoms. Persistently elevated blood pressure can damage the heart and blood vessels and increase the risk of cardiovascular and other diseases.
Dr Ashwani Kumar Sharma, Senior Consultant, Cardiology, CK Birla Hospital Jaipur, similarly points to high blood pressure as one of the major factors that can damage blood vessels and the heart over time.
Cholesterol and diabetes can add to the damage
High cholesterol is another risk factor that may remain invisible without a blood test. “Cholesterol increases the accumulation of atherosclerotic plaque in the body,” says Dr Chirag.
The World Heart Federation notes that excess cholesterol can contribute to plaque formation in the arteries, potentially narrowing or blocking blood flow.
Diabetes and persistently high blood sugar can also affect blood vessels. According to the World Heart Federation, people living with diabetes have a heightened risk of cardiovascular disease, with type 2 diabetes associated with roughly twice the risk of dying from heart disease and stroke compared with people without diabetes.
Dr Sharma also highlights obesity, particularly excess fat around the waist, because it can occur alongside hypertension, abnormal cholesterol and increased insulin resistance.
Smoking can accelerate cardiovascular damage
When people think about smoking, lung disease and cancer may be the first risks that come to mind. But tobacco also has a major impact on cardiovascular health.
“Smoking and tobacco consumption can cause the entire lining of the blood vessels to become damaged, resulting in a heart attack or stroke,” says Dr Ashwini.
Dr Chirag adds that smoking damages blood vessels, promotes inflammation and contributes to blood clotting.
The World Heart Federation identifies tobacco as a major preventable cardiovascular risk factor. Smoking and chewing tobacco can damage blood vessels, temporarily raise blood pressure and increase the risk of blood clots that can contribute to stroke and other cardiovascular events.
Your daily routine makes a significant difference
The factors that influence cardiovascular ageing are not limited to medical conditions. A sedentary lifestyle, unhealthy diet, excessive alcohol consumption and ongoing stress can all contribute to cardiovascular risk.
Dr Siotia recommends regular physical activity, maintaining a healthy body weight, eating a balanced diet, avoiding tobacco and limiting alcohol as part of prevention.
Dr Sharma also highlights diets high in salt, refined foods and saturated fats, alongside physical inactivity and prolonged stress.
Sleep deserves attention too. “Poor quality sleep or unmanaged sleep may result in hypertension and other cardiovascular risk factors,” Dr Ashwini says.
What about family history and age?
Not every cardiovascular risk factor can be changed. Age and family history can influence a person’s cardiovascular risk, and Dr Siotia points out that genes can matter. Dr Sharma also categorises family history and age among the factors people cannot alter.
But that does not mean cardiovascular risk is predetermined. “The risk of cardiovascular disease is not static,” says Dr Chirag. Blood pressure, cholesterol, blood glucose, smoking habits, exercise and weight are among the factors that can be monitored and, where appropriate, improved through lifestyle changes or treatment.
Modern cardiovascular risk tools also use several of these variables to estimate future risk. The American Heart Association’s PREVENT equations, for example, incorporate factors including age, blood pressure, cholesterol, kidney function, body mass index, diabetes and smoking status to estimate cardiovascular risk. The tool can also translate the estimated risk into a PREVENT-Age or “heart age”.
A heart age that is higher than someone’s chronological age indicates higher-than-expected predicted cardiovascular risk compared with peers. It does not mean the person’s heart has literally aged to that number.
You do not have to wait for symptoms
The biggest message from the three cardiologists is that prevention should happen before the heart sends out a warning.
“Don’t wait until symptoms appear, make the most of the health checks available,” says Dr Sharma.
Dr Siotia recommends keeping track of blood pressure, blood sugar and cholesterol, while discussing appropriate screening with a doctor if someone has a strong family history or multiple risk factors.
High blood pressure and abnormal cholesterol can exist without obvious symptoms and regular checks can identify problems that might otherwise go unnoticed.
As Dr Chirag puts it, the point of thinking about cardiovascular age is not to become anxious about a number. “The goal is not to look younger in numbers, but to avoid the damage to the blood vessels that ultimately leads to heart attack, stroke or heart failure.”
For World Heart Day, that may be the more useful way to think about your heart age. You cannot change the number on your birth certificate. You can, however, pay attention to the factors that influence what happens to your cardiovascular health over the years.
