Harvard Heart Letter

How old are your arteries?

You're as old as your arteries, which doesn't always equal the number of candles on your birthday cake.

Your arteries age more slowly and more gracefully than the rest of you when nurtured with daily exercise, a healthful diet, and good relationships with family and friends. They age faster when they're constantly assaulted by cigarette smoke, foods laden with saturated and trans fats, chronic stress, and other traumas. Knowing your vascular age can give you a clearer picture of your heart's health.

Two currently available tools estimate artery "age" using pulse wave velocity and carotid intima-media thickness. Measurement of these physical variables in thousands of people has allowed researchers to identify ranges for each that correspond to different chronological ages. A third tool that can be used at home relies on generally available information on age, cholesterol, and blood pressure.

Pulse wave velocity. Each heartbeat sends a wave of blood through the body's network of arteries. The stiffer the arteries, the faster this wave travels. Measuring the speed of the pulse wave provides information about how stiff or how flexible the arteries are. The speed of the wave can be converted into vascular age. Several companies make devices that measure pulse wave velocity in a doctor's office or at home using a small sensor that clips onto a finger.

Carotid intima-media thickness. The innermost layer of an artery's wall is called the intima; it provides a smooth surface for blood to flow through. The media is the middle layer; its muscle and elastic fibers let the vessel expand and contract with each heartbeat. The thicker the intima and the media, the more likely the artery is choked with cholesterol-filled atherosclerotic plaque. Using harmless ultrasound, a doctor can easily measure the intima-media thickness in the carotid arteries in the neck. This measurement can be used to estimate vascular age.

Framingham score. The landmark Framingham Heart Study has been following the health of thousands of residents of one Massachusetts town since 1948. Data accumulated in the study have helped researchers create a general cardiovascular risk profile. With answers to a few questions (see below), this tool estimates your chances of having a heart attack or stroke, needing bypass surgery or angioplasty, or developing peripheral vascular disease or heart failure. It also estimates your vascular age.

What's your 10-year risk of cardiovascular disease (CVD)?

Step 1: Calculate your cardiovascular risk points

Tally up your points from the six categories below.

Risk factor

Points

Men

Women

1. Age

30 – 34

0

0

35 – 39

2

2

40 – 44

5

4

45 – 49

6

5

50 – 54

8

7

55 – 59

10

8

60 – 64

11

9

65 – 69

12

10

70 – 74

14

11

75+

15

12

2. Total cholesterol

<160

0

0

160 – 199

1

1

200 – 239

2

3

240 – 279

3

4

280+

4

5

3. HDL cholesterol

<35

2

2

35 – 44

1

1

45 – 49

0

0

50 – 59

–1

–1

60+

–2

–2

4. Choose A or B.

A. Systolic blood pressure (not treated)

<120

–2

–3

120 – 129

0

0

130 – 139

1

1

140 – 149

2

2

150 – 159

2

4

160+

3

5

B. Systolic blood pressure (treated)

<120

0

–1

120 – 129

2

2

130 – 139

3

3

140 – 149

4

5

150 – 159

4

6

160+

5

7

5. Smoker?

No

0

0

Yes

4

3

6. Diabetes?

No

0

0

Yes

3

4

Your total

Step 2: Convert points to risk

Find your total points (top row) to determine your vascular age (bottom rows).

Total points

≤-1

0

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17+

Vascular age: Men

<30

30

32

34

36

38

40

42

45

48

51

54

57

60

64

68

72

76

80+

Vascular age: Women

<30

<30

31

34

36

39

42

45

48

51

55

59

64

68

73

79

80+

80+

80+

Thomas Sydenham, a 17th century physician who has been called the English Hippocrates, once said that "a man is as old as his arteries." To gauge the age of your arteries, you can ask your doctor to measure your pulse wave velocity or carotid intima-media thickness. But since most insurance companies don't pay for these tests, the Framingham estimate is a good place to start unless you don't mind getting an extra bill for this information.