How Old is Your Heart?

There are lots of online health tests available, some I’ve reviewed on Sciencebase over the years, such as those that help you answer the question are you at risk of diabetes. Often they are created and publicised by a medical charity, occasionally they are marketing devices posted by companies hoping to sell more of their product.

The Flora Heart Age tool, one might say, falls into both categories, although the press release suggests that the tool created by food company Unilever and the World Heart Federation is part of a new global initiative to reduce heart disease. There’s a nice little video that goes with the heart age tool to help you get the most out of it:

The Heart Age Tool helps you to estimate your heart health and express it as an estimated heart age, which can be older, younger or the same as one’s chronological age. The basic idea is to jolt those who display the higher risk factors for cardiovascular disease into making diet and lifestyle changes to reduce their heart age.

Needless, to say, I gave the tool a try, and worryingly it tells me my heart is 6 years older than me. However, there is a question regarding medication one might be taking that is not appropriately specific given that some medication for controlling high blood pressure can apparently have a beneficial effect on the heart above and beyond lowering blood pressure. With this in mind, I contacted the expert cited in the press release and asked a few questions about my results.

Dr Mark Cobain explained that the tool is not suitable for someone with a pre-existing heart problem as the risk models on which it is based were developed to estimate risk of a “first” cardiovascular event. Well, I have marginal hypertension, but have not had a first event, so it should be okay for me to take the test.

Those models, by the way were published in the cardiology journal Circulation in January 2008. That paper describes a sex-specific multivariable risk factor algorithm that can be used to assess general cardiovascular disease risk and risk of individual events. It concludes that, “the estimated absolute CVD event rates can be used to quantify risk and to guide preventive care.”

Cobain also pointed out that, “It is well recognised that the risk associated with a given blood pressure is not equivalent for those who are on medication and those who have the same blood pressure without medication.” This has been demonstrated with observational data and in clinical trials of all types. As such, the Heart Age Tool adjusts for blood pressure medication regardless of drug type being used. Which perhaps accounts for the lack of a modulating benefit for the antihypertensive yours truly was prescribed.

There is one additional point I wanted to know about – cholesterol. “When we piloted the Heart Age Tool,” Cobain explains, “we realised that only 20% of people know their cholesterol levels and to avoid over-burden on healthcare systems we required a different CVD risk model, which does not require cholesterol.” He and his colleagues have also published details of their non-cholesterol heart age model in Circulation. Moreover, the same approach was taken in a paper published shortly after in The Lancet by a group at Harvard Medical School and also recommended by the World Health Organization.

Cobain told me that to get the most accurate assessment of Heart Age we recommend finding your cholesterol value. There could be hope for me yet, if my cholesterol turns out to be healthily low…although there is some research that looks at homocysteine levels as a risk factor too.

“On homocysteine, the jury is still out,” Cobain told me. “We have been looking at this for some time and whilst it has shown it is related to CVD, the homocysteine
lowering trials to date don’t work, so this calls into question whether it is a causative agent or a bystander.”

Indeed, none of the CVD risk scores (Framingham, Q-RISK, SCORE, PROCAM etc) use homocysteine because no convincing data is yet available as to the role of this compound in heart disease risk. “It’s a shame because B-vitamins [which could control it] are cheap and if that had an impact it would have a big public health benefit,” added Cobain.

Gratifyingly, Cobain thanked me for my probing questions and added that the team is continuing to update the tool as new data become available and based on public
responses to improve its efficacy over time. “Heart Age isn’t a diagnostic tool,” he emphasises, “but we hope that it will help people think about their own heart health and motivate continuous efforts to reduce CVD risk factors.”

Research Blogging IconD’Agostino, R., Vasan, R., Pencina, M., Wolf, P., Cobain, M., Massaro, J., & Kannel, W. (2008). General Cardiovascular Risk Profile for Use in Primary Care: The Framingham Heart Study Circulation, 117 (6), 743-753 DOI: 10.1161/CIRCULATIONAHA.107.699579

Author: bob投注平台

Award-winning freelance science writer, author of Deceived Wisdom. Sharp-shooting photographer and wannabe rockstar.