Your Heart May Be Older Than You Are

Your Heart May Be Older Than You Are

SHIRLEY S. WANG

Feb. 24, 2014 8:20 p.m. ET

We all know we should eat healthier, exercise more and sometimes take medicines to stave off heart disease. Some researchers think putting an age on our hearts will do a better job of motivating us to do all that.

In a recent study involving 3,000 patients, researchers in Spain compared a relatively new tool to measure heart-disease risk, called Heart Age, against a commonly used risk-assessment tool. Participants who were told their heart age was greater than their chronological age showed bigger health improvements a year later than those in the comparison group. Both groups were healthier after a year than a control group that received conventional advice about nutrition and exercise.

A checkup at the doctor, of course, may alert patients when blood pressure and cholesterol levels, among other risk factors, are too high. And a number of statistical tools let patients know when they are at moderate-to-high risk of an adverse cardiovascular event, such as a heart attack. Having risk information, however, often has little effect on patients’ behavior, according to a 2010 review published in the Archives of Internal Medicine, a journal now named JAMA Internal Medicine.

More than 700,000 Americans have heart attacks each year and a quarter of all people in the U.S. die from heart disease, according to the Centers for Disease Control and Prevention.

Heart Age, a free Web-based tool owned by consumer-goods maker Unilever,ULVR.LN +1.44% combines various risk factors, such as body weight, cholesterol and smoking habits, to estimate a biological age for the heart. The result is framed relative to a person’s chronological age. The researchers on the Spanish study, published in the February issue of the European Journal of Preventive Cardiology, aren’t affiliated with Unilever.

Andy Skinner, a building-restoration expert who lives near Bridgnorth in central England, took the Heart Age quiz at a health-screening day at his local soccer club in October. He says he is active, rarely drinks and has no family history of heart disease. Yet Mr. Skinner, who is 52 years old, was told that his heart age was 58.

“That’s two years away from 60 and that’s scary,” says Mr. Skinner. “You actually start to think what I am doing wrong?”

Mr. Skinner says he found the concept of age easier to grasp than, for instance, his blood-pressure readings. He knew he could improve his diet so, among other changes, he stopped bringing white bread-and-cheese sandwiches for lunch and instead brings flasks of soup. Mr. Skinner has since been recruited to serve as an unpaid advocate for the program. He plans to retake the test in April to see if his score has changed.

Take to Heart

Heart-risk-assessment tools gauge a person’s risk for an adverse cardiovascular event, such as a heart attack. Here are some factors used to calculate that risk:

Chronologic age: As people get older, the heart muscle can stiffen, reducing pumping efficiency. Valves also might deteriorate.

Blood pressure: Hypertension puts more strain on the heart, making it pump harder.

Cholesterol: A buildup of plaque narrows the blood vessels, forcing the heart to work harder to circulate blood around the body.

Waist circumference: A large waist can indicate high levels of visceral, or organ, fat, which represents a greater risk for cardiovascular conditions than fat found under the skin or around muscles.

Gender: Because of hormonal differences, women tend to develop heart disease roughly 10 years later than men.

Sources: American Heart Association; Heart Age

Other online tools also measure heart age. The thinking is that people will try to narrow any difference between their heart age and their real age.

Mark Cobain, the London-based chief scientific officer of Heart Age, in 2003 began working on a Unilever program on healthy aging. He went to Massachusetts to learn from researchers with the Framingham Heart Study, one of the largest and longest-running heart-health studies.

Framingham scientists have been working for decades to figure out the most accurate way of predicting future cardiovascular problems. The scientists continually update their widely used measure that assesses an individual’s risk of having a heart attack in the next 10 years. The score reflects a type of risk called absolute risk, which is the overall chance an individual has of developing a disease.

With Framingham’s tool, someone with a score of 20% or greater is considered high risk and should consider taking medication and making lifestyle changes. Some doctors say it is the most useful tool for making treatment decisions. The problem: The number often sounds small, even for high-risk patients. Because it is designed to assess risk over 10 years, people may not understand their longer-term risks.

Dr. Cobain, who is trained as a psychologist, wanted to make the Framingham score more easily understood. Most people don’t understand risk, he says, but one number they do understand: their age.

Hearing the age of your heart is older than your real age “prods people to take action,” Dr. Cobain says. On the first page of the Heart Age tool, for instance, a man who is 45 years old will learn that, on average, men his age have a heart age six years older than their real age, based on the tool’s database of users.

Dr. Cobain cautions that the Heart Age score shouldn’t be used as a basis for treatment decisions because there haven’t been any studies looking at how big an age discrepancy should be to be considered high risk or warrant action. He says patients should talk with their doctor about any need for treatment. In the future, the Unilever-owned tool may offer products for purchase at the end of the test, but Heart Age itself will remain free, Dr. Cobain says.

Pedro Tauler, lead researcher in the recent Spanish study, says he and his team chose to study the Heart Age tool because they thought the idea held promise. They compared it against the Framingham score, which is well known and has been translated into Spanish, says Dr. Tauler, a professor in the department of fundamental biology and health sciences at the University of the Balearic Islands in Mallorca, Spain.

After a year, the health of the control group’s participants, who only got advice on a healthy lifestyle, didn’t improve. Subjects who received their Framingham risk score showed some improvement in blood-pressure and cholesterol control. The biggest improvements were among the participants who had been presented with a Heart Age score.

The main difference between the risk-assessment tools is in their expression of cardiovascular risk, Dr. Tauler says. Although the researchers expected participants to be able to understand more easily the concept of the age of the heart, they were surprised by the relative strength of the findings, he says. Dr. Tauler plans to run another study comparing the risk-assessment tools while adding a more intensive intervention to improve the health results even more.