Decoding the links between biological age and cardiovascular and brain health

08 Nov 2023 --- Two recent studies conducted in the US and Sweden highlight the link between a lower biological age and improved both cardiovascular and neurological health. Meanwhile, lifestyle changes such as healthy diets and managing weight, have been shown to reduce biological age.

At the upcoming American Heart Association’s Scientific Sessions 2023 taking place from November 11-13, researchers will present a study indicating that people with a better cardiovascular health had a lower biological age, suggesting that “improving cardiovascular health may decelerate biological aging and reduce associated morbidity.” 

“Phenotypic age is a robust marker of the body’s aging rate and is a strong predictor of future risk of chronic disease and mortality,” Nour Makarem, study senior author and assistant professor of epidemiology at the Columbia University Irving Medical Center, tells Nutrition Insight.

On average, those with a healthy cardiovascular system were found to be six years younger biologically than their chronological age, even after accounting for a range of socio-economic factors.

Meanwhile, research recently conducted at the Karolinska Institutet in Sweden and published in the BMJ Journal of Neurology, Neurosurgery and Psychiatry indicates a link between high biological age and a higher risk of dementia and stroke, even when other risk factors such as genetics, lifestyle and socio-economics are taken into account.

Jonathan Mak, co-author and researcher at the Department of Medical Epidemiology and Biostatistics at the Karolinska Institutet, Sweden, tells us that among the 18 biomarkers used to calculate biological age, some showed a stronger correlation with the risk of stroke and dementia. Phenotypic age is a marker of the body’s aging rate and is a predictor of future risk of chronic disease and mortality, experts say. 

“We found that blood pressure and blood glucose levels had strong links to stroke risk, likely reflecting vascular changes in the brain that can lead to stroke. Reduced lung capacity also strongly predicted both stroke and dementia risk. Although the mechanisms are complex, this could stem from systemic inflammation and oxygen deprivation damaging the brain over time,” he explains.

Biological age and health 
Makarem’s study examined the link between heart and brain health as measured by the American Heart Association’s “Life’s Essential 8” checklist and the phenotypic age. This checklist includes eight recommendations to improve heart health, including to eat better, manage weight, control cholesterol and manage blood sugar.

The study’s findings support the idea that improving cardiovascular health through these tips may decelerate biological aging, potentially leading to a longer, healthier life. The researchers used nine blood markers routinely captured during clinical visits to assess metabolism, inflammation and organ function. 

“It is a measure of biological aging that can be readily captured from someone’s chronological age and routine clinical chemistry biomarkers, including albumin, creatinine, glucose, C-reactive protein, lymphocyte percent, mean cell volume, red blood cell distribution width, alkaline phosphatase and white blood cell count,” Makarem explains.

“We found that higher cardiovascular health is associated with decelerated biological aging, as measured by phenotypic age. We also found a dose-dependent association — as heart health goes up, biological aging goes down.”

The findings by the Karolinska Institutet revelations about the increased risk of stroke and dementia associated with higher biological age also emphasize the urgency of addressing biological aging.

“If a person’s biological age is five years higher than their actual age, the person has a 40 percent higher risk of developing vascular dementia or suffering a stroke,” says Mak.

Lifestyle changes can slow aging
Makarem recommends that individuals consume “a healthy diet that is more plant-based, emphasizing fruits, vegetables, legumes and whole grains while limiting intake of added sugar, processed food and red meat.” 

She further advises against nicotine products and recommends being physically active and getting enough sleep. “At least seven hours but less than nine each night is also associated with decelerated biological aging.”

“It is important to note that there was a dose-response association for all of Life’s Essential 8 components. This means that even gradual improvements in lifestyle behaviors can be very meaningful for slowing down the body’s aging process and for living more years of life healthily,” she continues. 

Mak agrees that regular physical activity and a healthy, balanced diet “appear to be most effective at slowing down biological aging based on current evidence.” He notes that exercise may improve cardiovascular health while nutrition provides protective antioxidants. Low biological age is associated with the consumption of a healthy diet that is more plant-based.

“In terms of medication, our previous research suggests antihypertensive drugs could potentially decrease biological age, but that study was observational, so clinical trials are needed to confirm this,” he adds. 

In a recent case study, women reduced their biological age in eight weeks by following a program focusing on a healthy diet and lifestyle.

Future research 
Addressing the need for further studies to assess the long-term effects of improved cardiovascular health on biological age and overall health outcomes, Makarem says: “We need longitudinal studies to determine how changes in cardiovascular health across the life course influence the biological aging process over time.”

“We also need to study cardiovascular health in relation to other measures of biological aging,” she adds. 

Mak tells us it’s critical to improve understanding of the causality between biological age and diseases like stroke and dementia. “Beyond clinical trials, analyzing genetic variants randomly assigned at birth could help establish whether biological aging directly influences disease risk. These genetic approaches will provide important evidence on causality, guiding the development of anti-aging therapies to promote healthspan.”

Recently, researchers at the Karolinska Institutet developed a new DNA methylation clock, said to presently be the most accurate tool for measuring biological age. 

By Milana Nikolova