Quantitative Analysis of Heart Age Metrics: A Multi-Standard Assessment in the UK Biobank Cohort

Cardiovascular disease (CVD) stands as the leading global cause of illness, death, and financial burden in healthcare. Aging, an unavoidable and natural process, contributes to the development of CVD through physiological changes such as arterial stiffening and vascular dysfunction, making it a critical factor in assessing cardiovascular health. Consequently, heart age estimating the biological age of the cardiovascular system based on risk factors, has emerged as a valuable tool for identifying individuals at elevated risk and communicating cardiovascular health in a relatable way. In this paper, we discuss the mechanisms of human aging related to CVD, and assess how well previously established heart age metrics align with chronological age using a more current database. To the best of our knowledge, this is the first study systematically comparing different definitions and corresponding results of heart age, and analyzing the parameters required for these definitions using a subset of the UK Biobank database (n=387,574) to compare heart age differences under widely adopted standards, including the Framingham Risk Score (FRS) and Systematic COronary Risk Evaluation (SCORE). Our analysis examines heart age distributions by sex, age group, and other parameters to assess their relationship with chronological age. The results indicate that there are noticeable differences in the definitions of heart age, with calculated heart age averaging 11% higher than their chronological age based on the previously established definitions. These findings highlight the need to revisit and refine heart age metrics to enhance their utility in cardiovascular and cerebrovascular risk assessment as lifestyle and environmental risk factors evolve. © 2025 IEEE.