(© Win Nondakowit - stock.adobe.com)
New study reveals stark health disparities: Americans with less education and lower incomes have hearts aging up to a decade faster than their chronological age
In A Nutshell
- On average, American women’s hearts function about 4 years “older” and men’s about 7 years “older” than their chronological age.
- Among adults with only a high‐school diploma, roughly 23 % of women and 33 % of men have hearts aging > 10 years beyond their age.
- Lower‐income groups (≤2× poverty level) show similarly stark gaps: 24 % of women and 35 % of men exceed a 10-year heart-age difference.
- The AHA’s PREVENT risk-age calculator translates abstract percentages into “heart age” to motivate lifestyle changes.
CHICAGO — A 45-year-old walks into a doctor’s office for a routine checkup, only to discover their heart is functioning like that of a 55-year-old. For millions of Americans, this scenario reflects a new reality uncovered by researchers: cardiovascular systems are aging faster than actual age, with dramatic disparities along socioeconomic lines.
A study published in JAMA Cardiology found that the average American’s cardiovascular system ages faster than their actual age, with women’s hearts typically acting about 4 years older and men’s hearts about 7 years older than their chronological age. More concerning: Americans with less education and lower incomes face cardiovascular aging that can outpace their actual age by a decade or more.
Among adults with a high school education or less, nearly one in four women and one in three men have a heart age that is more than 10 years older than their actual age. The gap shrinks for those with higher education levels, revealing a health divide that tracks closely with socioeconomic status.
The research introduces “risk age,” a new way for doctors to communicate heart disease risk that could replace confusing statistical percentages with a more relatable concept: how old your heart really is.
Which Americans Face the Fastest Heart Aging
Northwestern University researchers analyzed data from 14,140 participants representing approximately 138 million American adults aged 30 to 79 without existing heart disease. They used a newly developed heart age calculator to determine each person’s “risk age,” essentially the age of someone with perfect cardiovascular health who would face the same heart disease risk.
Perfect cardiovascular health meant having cholesterol levels of 120 mg/dL, blood pressure of 110 mm Hg, normal kidney function, no diabetes, not smoking, and not needing blood pressure or cholesterol medications.
Results revealed dramatic variations across demographic groups. Non-Hispanic Black adults faced the largest gaps, with women’s cardiovascular systems aging an average of 6.2 years beyond their actual age and men’s aging 8.5 years beyond their real age. Hispanic adults also showed substantial differences, particularly men, whose cardiovascular systems aged nearly 8 years faster than their chronological age.
Non-Hispanic Asian adults fared best, showing the smallest cardiovascular aging gaps: less than 3 years for women and about 6.7 years for men.
How Education and Income Drive Heart Health Disparities
Educational attainment emerged as a powerful predictor of how fast hearts age. Adults with more than a high school education showed much smaller gaps between their risk age and actual age: about 3.3 years for women and 6.2 years for men. Those with only high school education or less faced much larger gaps of 5.8 years for women and 7.9 years for men.
lncome created an even starker divide. Adults with family incomes at or below twice the poverty level showed cardiovascular aging that far exceeded their chronological age: nearly 6 years for women and more than 8 years for men. Higher-income groups showed much smaller gaps of about 3 years for women and 6 years for men.
Among lower-income adults, 24.4% of women and 35.4% of men had cardiovascular systems aging more than 10 years beyond their actual age. For higher-income groups, these percentages dropped to 12.2% for women and 22.8% for men.
How Doctors Could Use ‘Heart Age’ to Motivate Patients
Risk age calculations represent a shift from traditional cardiovascular risk communication. Instead of telling patients they have a 15% chance of heart disease in the next decade (an abstract concept many struggle to understand), doctors could explain that someone’s heart functions like that of a person 10 years older.
PREVENT equations, developed by the American Heart Association, provide more accurate cardiovascular risk assessments than previous tools by including kidney function measurements alongside traditional factors like blood pressure, cholesterol levels, diabetes status, and smoking habits.
Researchers created an online calculator that healthcare providers could use to show patients both their absolute cardiovascular risk and their risk age, potentially making prevention conversations more concrete and motivating.
Risk age calculations could prove especially valuable for younger adults who may have low absolute risk percentages but elevated risk relative to their age group, potentially providing stronger motivation for lifestyle changes.
Beyond Individual Choices: The Bigger Picture
The dramatic disparities in cardiovascular aging reflect broader patterns of health inequality in American society. Education level and income powerfully predict cardiovascular aging, indicating that addressing heart disease risk requires looking beyond individual lifestyle choices to broader social and economic factors that shape health opportunities.
Researchers acknowledged limitations in their approach, noting that defining “optimal” risk factors could influence risk age calculations. They emphasized that prospective studies are needed to determine whether communicating risk age actually improves patient motivation for lifestyle changes, adherence to preventive treatments, and health outcomes compared to traditional methods.
As cardiovascular risk assessment tools continue evolving, the concept of risk age offers both promise for better patient communication and a sobering reminder of how deeply health inequities are embedded in American society. The question extends beyond whether someone’s heart ages faster than expected; it’s why some Americans’ hearts age decades faster than others, and what systemic changes could close these gaps.
To check your heart age using the online calculator, click here.
Paper Summary
Methodology
Researchers developed sex-specific “risk age” equations based on PREVENT cardiovascular disease risk assessment tools. They analyzed data from the National Health and Nutrition Examination Survey (2011-2020), studying 14,140 participants aged 30-79 without existing cardiovascular disease, representing about 138 million American adults. Risk age was calculated as the age of a hypothetical person with optimal risk factors (specific cholesterol, blood pressure, kidney function, diabetes, and smoking status) who would have the same 10-year cardiovascular disease risk as each participant.
Results
Average cardiovascular risk age exceeded chronological age by 4.1 years for women and 6.9 years for men. Notable disparities emerged across demographic groups: 22.8% of women and 32.5% of men with high school education or less had risk ages more than 10 years older than their actual age. Non-Hispanic Black adults showed the largest discrepancies (6.2 years for women, 8.5 years for men), while Non-Hispanic Asian adults showed the smallest gaps. Lower-income adults faced substantially larger age discrepancies than higher-income groups.
Limitations
The study acknowledged that defining “optimal” risk factors could influence risk age calculations. The research was cross-sectional, so it couldn’t establish causation or track changes over time. The authors noted that prospective studies are needed to assess whether communicating risk age actually improves patient motivation and health outcomes compared to traditional risk communication methods.
Funding and Disclosures
Dr. Greenland reported grants from the National Institutes of Health and American Heart Association. Dr. Lloyd-Jones serves as an unpaid director of the American Heart Association. Dr. Khan reported grants from the American Heart Association and National Heart, Lung, and Blood Institute. Dr. Khan is an associate editor of JAMA Cardiology but wasn’t involved in the manuscript review process.
Publication Information
The study “PREVENT Risk Age Equations and Population Distribution in US Adults” was published online July 30, 2025, in JAMA Cardiology. The research was conducted by investigators from Northwestern University Feinberg School of Medicine, Boston University, NYU Grossman School of Medicine, and Johns Hopkins University School of Medicine.
“Education level and income powerfully predict cardiovascular aging, indicating that addressing heart disease risk requires looking beyond individual lifestyle choices to broader social and economic factors that shape health opportunities.”
You don’t think lifestyle choices are HIGHLY correlated with education level and income?
ESPECIALLY education level?
Isn’t it mostly poor people who still smoke tobacco? Isn’t it mostly poor people who are HEAVY users of pot? Isn’t it almost entirely poor people who smoke meth (or who quickly _become_ poor)?
Isn’t it now poor people who don’t have time to cook, and so rely heavily on processed foods? Or time (much less a membership) to workout? Isn’t it mostly people who don’t read who don’t know what is/isn’t healthy — and aren’t reading habits heavily correlated with income?
Only a little of the above is directly _caused_ by not having much money.