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Comparative Study
. 2019 Jul/Aug;134(4):404-416.
doi: 10.1177/0033354919849881. Epub 2019 May 16.

Heart Age, Cardiovascular Disease Risk, and Disparities by Sex and Race/Ethnicity Among New York City Adults

Bahman P Tabaei  1 , Shadi Chamany  1 , Sharon Perlman  1 , Lorna Thorpe  2 , Katherine Bartley  1 , Winfred Y Wu  1
Affiliations
Comparative Study

Heart Age, Cardiovascular Disease Risk, and Disparities by Sex and Race/Ethnicity Among New York City Adults

Bahman P Tabaei et al. Public Health Rep. 2019 Jul/Aug.

Abstract

Objectives: Cardiovascular disease (CVD) is the leading cause of mortality in the United States. The risk for developing CVD is usually calculated and communicated to patients as a percentage. The calculation of heart age-defined as the predicted age of a person's vascular system based on the person's CVD risk factor profile-is an alternative method for expressing CVD risk. We estimated heart age among adults aged 30-74 in New York City and examined disparities in excess heart age by race/ethnicity and sex.

Methods: We applied data from the 2011, 2013, and 2015 New York State Behavioral Risk Factor Surveillance System to the non-laboratory-based Framingham risk score functions to calculate 10-year CVD risk and heart age by sex, race/ethnicity, and selected sociodemographic groups and risk factors.

Results: Of 6117 men and women in the study sample, the average heart age was 5.7 years higher than the chronological age, and 2631 (43%) adults had a predicted heart age ≥5 years older than their chronological age. Mean excess heart age increased with age (from 0.7 year among adults aged 30-39 to 11.2 years among adults aged 60-74) and body mass index (from 1.1 year among adults with normal weight to 11.8 years among adults with obesity). Non-Latino white women had the lowest mean excess heart age (2.3 years), and non-Latino black men and women had the highest excess heart age (8.4 years).

Conclusions: Racial/ethnic and sex disparities in CVD risk persist among adults in New York City. Use of heart age at the population level can support public awareness and inform targeted programs and interventions for population subgroups most at risk for CVD.

Keywords: Behavioral Risk Factor Surveillance System; cardiovascular diseases; ethnic groups; gender; health status disparities; risk factors.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure.
Figure.
Excess heart age attributable to modifiable cardiovascular disease (CVD) risk factors (body mass index [BMI], current smoking, systolic blood pressure [SBP]), by sex, race/ethnicity, and chronological age, among adults in New York City aged 30-74, New York State Behavioral Risk Factor Surveillance System, 2011, 2013, and 2015. Heart age is defined by identifying the chronological age of a person with the same predicted Framingham Risk Score–derived 10-year CVD risk but normal levels of CVD risk factors. Excess heart age (heart age greater than chronological age) connotes increased CVD risk. Prevalence of excess heart age ≥5 years indicates the proportion of the population with a heart age at least 5 years older than their chronological age and therefore at greater risk for CVD event. Data source: New York State Behavioral Risk Factor Surveillance System (BRFSS). Data were weighted for the New York City adult population. Error bars indicate 95% confidence intervals.
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