Your heart age is not a measurement of your heart. It is your heart disease risk, restated as an age. If your risk matches that of a typical 60-year-old, a calculator tells you your heart age is 60, whatever your birth certificate says.
"Vascular age" and "arterial age" work the same way, but some versions are based on a scan of your arteries instead of a questionnaire. All of them are ways of explaining risk. None of them is a diagnosis.
Key takeaways
- Heart age is your heart disease risk expressed as an age, not a measurement of your heart.
- Arterial age from a calcium score has the best evidence, but the scan cannot see soft plaque.
- Vascular age from a CIMT ultrasound adds little to prediction, and US guidance does not recommend routine CIMT.
- A calculator-based heart age improves when blood pressure, cholesterol, smoking or blood sugar improve.
- Treat any claim that a product or program can make your arteries younger with caution.
What a heart age calculator does
Most online heart age tools take the same inputs as a standard risk calculator: age, sex, blood pressure, cholesterol or body mass index, smoking and diabetes. They work out your risk, then find the age at which a person with ideal values for those factors would have the same risk. That age is your heart age.
The CDC defines heart age as the predicted age of your vascular system based on your risk factor profile.1 The idea is that an age is easier to grasp than a percentage.
An older heart age is common. In a CDC analysis of US adults aged 30 to 74, the average heart age was 7.8 years older than actual age for men and 5.4 years older for women.1 A result a few years above your real age is worth acting on, but it is not a sign of unusual danger.
Because heart age is risk in different units, it has the same blind spots as the calculator behind it. Our guide to the PREVENT risk calculator covers what those calculators include and what they leave out, such as family history and Lp(a).
Arterial age from a calcium score
A second kind of age comes from imaging. A coronary artery calcium (CAC) scan measures calcified plaque in the heart's arteries. Because that score has real predictive value, it can be translated into an age.
The best known method comes from the MESA study. Researchers in the MESA study, which followed 6,814 adults without heart disease, built a formula that converts a calcium score into an arterial age by matching it to the age that carries the same coronary risk.2 A 55-year-old with more calcium than expected might be given an arterial age of 65.
In that study, a risk estimate that used arterial age predicted coronary events over the next few years somewhat better than one that used actual age. That makes CAC-based arterial age the most evidence-based of the "age" numbers. It still has limits. A calcium scan does not see soft plaque, so a score of zero gives a young arterial age without proving the arteries are clear. Our article on calcium score by age explains how scores compare across ages and what a percentile means.
Vascular age from a CIMT ultrasound
A third version uses a carotid intima-media thickness (CIMT) ultrasound. The scan measures the thickness of the wall of the carotid arteries in your neck. That thickness is compared with typical values for your age and sex, and the report may say your arteries look like those of someone older or younger.
This number needs the most caution. A thicker wall is not the same thing as plaque. The evidence that it sharpens prediction is weak. A meta-analysis of 14 cohorts with 45,828 people found that adding CIMT to a standard risk score improved 10-year prediction only slightly, an amount the authors judged unlikely to matter clinically.3
US guidance from 2013 does not recommend routine CIMT measurement for predicting a first cardiovascular event.4 What the ultrasound can add is a look for actual plaque in the neck arteries. A meta-analysis of 11 population studies found that carotid plaque predicted future heart attacks more accurately than wall thickness did.5 Our CIMT ultrasound guide goes through the test and its limits in detail.
How reliable are these numbers?
They are only as good as what they are built on. Here is how the three compare.
| Type | Based on | Main limit |
|---|---|---|
| Heart age (calculator) | Your risk factors, entered into a risk equation | An average for people like you. It does not look at your arteries. |
| Arterial age (CAC) | Calcified plaque seen on a heart CT | Misses soft plaque. Changes slowly, so it is a poor short-term tracker. |
| Vascular age (CIMT) | Carotid wall thickness on ultrasound | Adds little to prediction. Not recommended for routine use in US guidance. |
Different tools can also disagree. Each uses its own equation and reference population, so treat any result as a rough signal, not a precise reading.
Does hearing an age help people change? Less than you might hope. A 2021 systematic review found little evidence that heart age motivates lifestyle change more than a percentage does, although either format helped when combined with counseling or other support.6
What actually changes your heart age
A calculator-based heart age moves when its inputs move. That means the things you would expect:
- Lower blood pressure
- Lower cholesterol, or more precisely fewer of the particles that carry it
- Stopping smoking
- Preventing or controlling diabetes
- A healthier weight, where the tool uses body mass index
One input never improves: your real age. As the years pass, your heart age rises even if every other number holds steady.
Imaging-based ages behave differently. A calcium score reflects plaque that has built up over many years, so a CAC-based arterial age should be read as a baseline and not as a score to bring down. Be wary of any product or program that promises to make your arteries younger. What the evidence supports is lowering the risk of heart attack and stroke by treating the risk factors.
Your next step: look past the single number
If a heart age result has you concerned, the useful move is to see what is driving it. Our guide to the coronary calcium score explains the test behind arterial age and who it may help.
You can also answer the three quick questions in the Cardio Res-Q screener on our program page to see whether a closer evaluation makes sense for you.
Are You a Candidate for Cardio Res-Q?
Three quick questions about the risk factors we screen for. Your answers stay between you and the clinic.
Frequently asked questions
My heart age is older than my real age. Should I be worried?
Take it as a prompt, not a verdict. An older heart age is the usual result for US adults, and it means one or more risk factors are above ideal. Find out which ones, and talk to your clinician about what to do about them.
Can I lower my heart age?
A calculator-based heart age falls when blood pressure, cholesterol, smoking status or blood sugar improve, because those are its inputs. An arterial age based on a calcium score is different. It reflects plaque that has already formed and is best used as a baseline.
Is vascular age from a CIMT scan accurate?
It is a comparison with average wall thickness for your age, not a direct measure of risk. Studies show that wall thickness adds little to standard risk prediction, and US guidance does not recommend routine CIMT for that purpose. Plaque seen on the same ultrasound is the more meaningful finding.
Which is better, heart age or a risk percentage?
They carry the same information. Heart age is easier to remember, while the percentage is what guidelines use to make treatment decisions. If you are given a heart age, ask for the percentage behind it too.
Related reading
This article is for general education and is not medical advice. Decisions about testing and medication should be made with your clinician. If you have chest pain or other symptoms of a heart attack, call 911.
