Learn how biomarkers reveal your true cardiovascular biological age. Discover key tests and take control of your heart health before symptoms start.
Many people focus on their chronological age, not knowing that their arteries are older than their actual age. That could mean your risk for a heart attack or stroke is higher than you think. Early signs of cardiovascular aging, like stiff arteries or plaque buildup, can start long before you feel anything wrong. These silent changes can quietly increase your risk over time.
Fortunately, specific tests and biomarkers can now measure how your cardiovascular system is aging. These include artery thickness scans, blood pressure wave checks, and molecular clues like DNA changes or telomere length.
In this article, we’ll explain the key tools used and how to measure your cardiovascular biological age.
These biomarkers evaluate how well your arteries are aging by assessing their thickness, stiffness, and ability to function properly, which are all key indicators of cardiovascular health.
Vascular aging refers to the identifiable age-driven changes in the structure and function of the arteries. These include arterial stiffness, intimal thickening, endothelial dysfunction, chronic inflammation, and a pro-atherogenic state.
According to a study, some older adults remain resilient with no cardiovascular disease, highlighting how structural and functional changes in the vasculature reflect both biological aging and disease susceptibility.
The changes in the vascular structures are often marked by the following:
The following tests help detect early changes in your arteries, such as thickening, calcification, stiffness, or poor dilation, that signal increased cardiovascular risk.
1. Carotid Intima-Media Thickness (IMT)
Carotid IMT measures the thickness of the inner two layers of the carotid artery wall. Increased IMT is associated with early atherosclerosis and elevated cardiovascular risk.
Greater IMT values correlate with a higher likelihood of cardiovascular events. For instance, a study highlighted that carotid IMT is a predictor of cardiovascular risk in multiple large studies.
Monitoring Carotid IMT can be a valuable tool in assessing cardiovascular risk, especially when combined with traditional risk factors. Early detection through IMT measurement allows for timely interventions, potentially reducing the likelihood of serious cardiovascular events.2. Coronary Artery Calcium Score (CACS)
CACS quantifies the amount of calcified plaque in the coronary arteries using CT imaging.
Higher scores indicate a greater burden of atherosclerosis and predict future cardiovascular events. According to a review, CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major cardiovascular outcomes.
How are scores interpreted?
3. Pulse Wave Velocity (PWV)
PWV is typically measured between two points in your body, such as the carotid artery in your neck and the femoral artery in your groin. The test calculates the speed at which blood pressure waves travel between these points.
Faster speeds indicate stiffer arteries. Increased PWV values are associated with higher cardiovascular risk.
A study demonstrated that estimated PWV is associated with cardiovascular and all-cause mortality in a large representative sample of US adults.
Another study has shown that PWV is a strong predictor of cardiovascular events and overall mortality. For instance, a study found that each 1 m/s increase in estimated PWV was associated with a 29% higher risk of death from any cause and a 34% higher risk of death from cardiovascular causes.
Important numbers and their implication in PWV.
4. Flow-Mediated Dilation (FMD)
FMD evaluates endothelial function by measuring the dilation of the brachial artery in response to increased blood flow.
FMD results are typically expressed as a percentage increase in artery diameter:
Research found that endothelial dysfunction, as indicated by reduced FMD, is an early marker of vascular aging and a predictor of cardiovascular events.
Here’s a summary of tests used in measuring the vascular structure and function as a biomarker of cardiovascular risk.
Molecular and cellular markers serve as powerful indicators of cardiovascular disease (CVD) risk and progression. According to a study, in the context of cardiovascular aging, molecular markers include:
These signal early pathologic changes, often before symptoms occur.
These markers reflect deeper biological processes like aging, inflammation, and cellular damage that silently increase your risk for cardiovascular disease over time.
1. DNA methylation clocks
These epigenetic biomarkers estimate biological age by analyzing DNA methylation patterns. Accelerated DNA methylation age is linked to increased cardiovascular risk and mortality.
A review discussed how DNA methylation clocks are accurate predictors of human chronological age and have been related to mortality and age-related diseases.
This DNA methylation clock is specifically used for:
2. Telomere length
Telomeres are protective caps at the ends of chromosomes that shorten with each cell division. Shorter telomeres are associated with:
A study indicated that reduced telomere length in circulating leukocytes is associated with increased risk of myocardial infarction and heart disease.
Certain habits can influence how quickly your telomeres shorten.
Negative factors:
Positive influences:
3. Inflammatory biomarkers
Chronic inflammation contributes to vascular damage and plaque instability. Elevated levels of inflammatory markers like C-reactive protein (CRP) and interleukin-6 (IL-6) are linked to higher cardiovascular risk.
For example, in one study, involving patients with stable coronary heart disease found that higher IL-6 levels were independently associated with increased risks of:
Another study found that measuring circulating levels of common inflammatory biomarkers provides incremental prognostic information for cardiovascular risk.
4. Senescent cells in vascular tissue
Senescent cells are aged cells that no longer divide but release pro-inflammatory factors, disrupting tissue function. Their accumulation in vascular tissue impairs vessel repair and promotes calcification. This secretory profile can disrupt normal tissue function and contribute to disease processes.
According to studies, in vascular tissues, the accumulation of senescent cells, particularly vascular smooth muscle cells (VSMCs) and endothelial cells, can lead to several detrimental effects:
These changes can accelerate the development of atherosclerosis and increase the risk of cardiovascular events.
These advanced tools combine artificial intelligence, composite scoring, and molecular data to estimate how fast your cardiovascular system is aging, often before symptoms appear.
1. AI-Enhanced ECG and EHR tools
Artificial intelligence applied to electrocardiograms (ECGs) and electronic health records (EHRs) can estimate vascular biological age and identify discrepancies between biological and chronological age, which are linked to cardiovascular mortality.
AI algorithms examine ECG patterns, such as:
Studies have demonstrated the potential of AI-enabled ECGs in assessing biological age and predicting cardiac disease.
2. Composite scores
Composite biomarkers like the vascular aging index and proteomic age clocks offer advanced methods for assessing vascular health and aging.
By integrating multiple indicators, they provide a more nuanced understanding of cardiovascular risk, enabling earlier and more personalized interventions.
Research highlighted how organ-specific aging clocks, developed using plasma proteins, can model aging in major organs like the heart and predict disease risks.
3. Ageome system
The ageome system is a computational framework designed to assess biological aging by analyzing thousands of molecular pathways simultaneously.
The ageome approach offers a pathway-based map of biological aging, assessing various cellular pathways and functions simultaneously rather than providing a single age estimate.
This method allows for a more detailed understanding of how different parts of the body age at different rates.
Several factors, from daily habits to social conditions, can speed up or slow down how your arteries and heart age, directly affecting your cardiovascular risk.
1. Lifestyle factors
Unhealthy behaviors such as poor diet, physical inactivity, smoking, and excessive alcohol consumption accelerate vascular aging.
Experts emphasize that maintaining the following habits can positively impact how one ages:
Adopting healthy habits early in life yields the most significant benefits. A study emphasized that the decade between the ages of 36 to 46 is crucial for establishing routines that promote long-term heart health.
2. Chronic stress and inflammation
Persistent stress elevates inflammatory markers, leading to arterial damage over time. Chronic inflammation, driven by factors like:
Resulting in negative health concerns such as:
Researchers also say that chronic inflammation silently increases the risk of heart attacks.
3. Social determinants
Socioeconomic factors such as poverty, exposure to pollution, and limited access to healthcare contribute to accelerated vascular aging.
One research has shown that poverty, pollution, and unhealthy living conditions are associated with accelerated biological age and reduced longevity.
Another research emphasized that people with lower socioeconomic status often face more health challenges. They may experience higher levels of stress, have less access to healthcare, and live in environments that are not conducive to good health.
These factors can contribute to faster biological aging and increased risk of cardiovascular diseases.
Biomarkers guide decisions, personalize care, and help track whether your heart health is improving with treatment or lifestyle changes.
1. Risk stratification
Assessing biological age through biomarkers helps identify individuals at higher risk for early cardiovascular events, even if their chronological age is young.
A study emphasizes the importance of incorporating biomarkers into cardiovascular risk prediction models.
2. Personalized interventions
Personalizing therapies based on vascular age and biomarker profiles allows for more effective prevention and treatment strategies.
For example, interventions such as statins, anti-inflammatory medications, and lifestyle modifications can be guided by insights from DNA methylation clocks and other biomarkers.
An article discusses how understanding different aging rates across organs can inform targeted interventions to decelerate biological aging.
3. Tracking progress
Monitoring biomarkers over time enables evaluation of how well lifestyle or medical interventions are reversing vascular aging.
One example of a good monitoring tool is the ageome system, which examines many biological pathways in your body at once. It also provides a detailed map showing how different parts of your body are aging.
According to a study, ageome system, by providing a high-dimensional map of biological aging, allows scientists to assess aging comprehensively and track the effectiveness of interventions.
Chronological age is how many years you’ve lived. Biological age shows how “old” your body really is based on health and function.
Yes. Your heart and arteries can age faster if you have high blood pressure, poor lifestyle habits, or inflammation.
You might slow it down. Regular exercise, healthy food, less stress, and quitting smoking can help improve your vascular health.
They can. These markers spot early signs of damage, so you can take action before a heart attack happens.
