Cardiovascular events often seem to strike suddenly as we age, with some physicians arguing that they’re inevitable. Now a new JAMA Cardiology analysis suggests that the way our bodies age may clue-in cardiovascular trouble earlier than expected.
- The heart is a muscle, and like all muscles, its performance decreases with age due to wall thickening, stiffer valves, lower maximum heart rate, pacing issues, etc.
- Although we know what happens to the heart as we age, it’s less clear how other aging factors like frailty, brain function, and physical ability impact the heart.
To find the link between bodily aging and the heart, researchers followed 12k older adults (ages 65-70+ paired with matched controls) who were all free of prior CVD, dementia, or significant disability. They measured three aging criteria annually for 14 years – frailty, intrinsic capacity, and physical health-related quality of life.
- Frailty = calculated from the 64-item Frailty Index and Fried phenotype frailty
- Intrinsic capacity = a combo of cognitive, locomotor, vitality, and psychological features.
- Physical health-related QoL (HRQOL) = a 12-item short form physical exam.
Over the years an intriguing trend emerged: People who went on to have a CV event showed measurable functional decline across those three categories more than a decade beforehand.
- Specifically, those patients showed higher frailty, lower intrinsic capacity, and poorer physical HRQOL over the ten years leading to their CV event.
- Roughly five years before a CV event, those three aging factors compounded with each other, leading to accelerated bodily deterioration compared to control patients.
While those timelines sound frightening, not all CVD types developed on the same schedule.
- Patients who eventually developed HF and fatal coronary heart disease saw their functional decreases begin 10+ years before their first event.
- Meanwhile MI and stroke emerged after fewer years of deterioration, so they may have a shorter warning window when it comes to aging.
These outcomes might seem obvious, but the value of this study is the proposed timeline that measuring a patient’s functional decline can give us.
- In this case, factors like frailty, intrinsic capacity, and HRQOL may be an early way to detect the multisystem aging that culminates in CVD.
The Takeaway
Getting older is inevitable and immutable, but how we age may be more important for our cardiovascular health than we realize. This study gives a glimpse into that importance, and the clues a patient’s aging trajectory can give us for their CVD risk.
