Abstract
Introduction: Recent analysis of BRFSS data used the non-laboratory-based Framingham 10-year cardiovascular (CVD) risk calculator to derive biological heart age in older adults. . This calculator utilizes cardiovascular disease (CVD) risk factors sex, age, BMI, systolic blood pressure (SBP), diabetes status, smoking status and antihypertensive medication use. We examined which risk factors drove differences between biological and chronological heart age in young adults. Methods: CARDIA examined 2674 black and white men and women who attended Year 10 (mean age 34) and Year 25 (mean age 49) exams and had complete data for heart age components. Biological heart age was calculated using the non-laboratory-based Framingham 10-year CVD risk calculator. Heart age difference was defined as the difference between biological and chronological heart age, with higher values representing poorer heart age. Heart age difference was categorized into three levels, ≤-5 years, -5 to +5 years, or ≥+5 years. Differences between levels were assessed using linear regression, with heart age difference coded as an indicator variable referenced against a heart age difference of -5 and +5 years. Results: Race, smoking status, BMI and SBP were statistically significantly different from the reference in those whose heart age differences were lower (≤ -5) and higher (≥ 5) at exam years 10 and 25. Sex differed from the reference only in the lower heart age difference groups at both exams. Diabetes status differed from the reference only in the higher heart age difference groups at both exams. Conclusions: Most risk factors driving biological heart age, including race, smoking status, diabetes status, antihypertensive medication use, BMI and SBP, drive both favorable and unfavorable heart age differences at years 10 and 25 with the notable exceptions of female sex with favorable and diabetes with unfavorable heart age difference. This suggests that risk factor management at both younger and older ages impacts vascular aging.
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