Adhering to heart-healthy lifestyle factors like exercise, diet, and managing conditions like high blood pressure was associated with slower biological aging at a cellular level.

CI’s Three Key Takeaways:

  1. Following the American Heart Association’s “Life’s Essential 8” guidelines for heart health was linked to a 35% lower risk of developing cardiovascular disease, 36% lower risk of dying from cardiovascular disease, and 29% lower risk of death from any cause.
  2. Around 20% of the beneficial association between heart-healthy behaviors and reduced cardiovascular risks was estimated to be due to the positive impact on slowing biological aging at the cellular level, as measured by DNA methylation levels.
  3. For those genetically predisposed to accelerated biological aging, adhering to optimal heart health metrics had an even greater effect, accounting for up to 78% reduction in risks of cardiovascular disease, cardiovascular death, and overall mortality through the pathway of slower cellular aging.

The benefit of better heart health may be associated with the positive impact of heart-healthy lifestyle factors on biological aging, according to new research published in the Journal of the American Heart Association.

“Our study findings tell us that no matter what your actual age is, better heart-healthy behaviors and managing heart disease risk factors were associated with a younger biological age and a lower risk of heart disease and stroke, death from heart disease and stroke and death from any cause,” says Jiantao Ma, PhD, senior study author and an assistant professor in the division of nutrition epidemiology and data science at the Friedman School of Nutrition Science and Policy at Tufts University in Boston, in a release.

The Role of DNA Methylation

This study analyzed whether a chemical modification process known as DNA methylation, which regulates gene expression, may be one mechanism by which cardiovascular disease health factors affect cell aging and the risk of death. DNA methylation levels are the most promising biomarker to estimate biological age. To some degree, biological age is determined by your genetic makeup, and it can also be influenced by lifestyle factors and stress.

Researchers examined health data for 5,682 adults (mean age of 56 years; 56% of participants were women) who were enrolled in the Framingham Heart Study, an ongoing, large, multigenerational research project aimed at identifying risk factors for heart disease. 

Life’s Essential 8 Tool

Using interviews, physical exams, and laboratory tests, all participants were assessed using the American Heart Association’s Life’s Essential 8 tool. The tool scores cardiovascular health between 0-100 (with 100 being the best) using a composite of four behavioral measures (dietary intake, physical activity, hours slept per night, and smoking status) and four clinical measurements (body mass index, cholesterol, blood sugar, and blood pressure). 

Each participant was also assessed using four tools that estimate biological age based on DNA methylation and a fifth tool that assesses a person’s genetic tendency towards accelerated biological aging. Participants were followed for 11-14 years for new-onset cardiovascular disease, cardiovascular death, or death from any cause.

Key Findings

The analysis found:

  • For each 13-point increase in an individual’s Life’s Essential 8 score, the risk of developing cardiovascular disease for the first time was reduced by about 35%, death from cardiovascular disease was reduced by 36%, and death from any cause was reduced by 29%.
  • In participants with a genetic risk profile making them more likely to have an accelerated biological age, the Life’s Essential 8 score had a larger impact on outcomes potentially via DNA methylation, ie, DNA methylation accounted for 39%, 39%, and 78% reduction in the risk of cardiovascular disease, cardiovascular death, and all-cause death, respectively.
  • Overall, about 20% of the association between Life’s Essential 8 scores and cardiovascular outcomes was estimated to be due to the impact of cardiovascular health factors on DNA methylation; in contrast, for participants at higher genetic risk, the association was almost 40%.

“While there are a few DNA methylation-based, biological age calculators commercially available, we don’t have a good recommendation regarding whether people need to know their epigenetic age,” Ma says in a release. “Our message is that everyone should be mindful of the eight heart disease and stroke health factors: eat healthy foods; be more active; quit tobacco; get healthy sleep; manage weight; and maintain healthy cholesterol, blood sugar, and blood pressure levels.”

Consistency with Prior Research

Randi Foraker, PhD, MA, FAHA, co-author of the Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health, says the findings are consistent with prior research.

“We know that modifiable risk factors and DNA methylation are independently associated with cardiovascular disease. What this study adds is that DNA methylation may serve as a mediator between risk factors and cardiovascular disease,” says Foraker, who is a professor of medicine at the Institute for Informatics, Data Science and Biostatistics and director of the Center for Population Health Informatics, both at Washington University School of Medicine, in a release. “The study highlights how cardiovascular health can impact biological aging and has important implications for healthy aging and prevention of cardiovascular disease and potentially other health conditions.”

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