A recent scientific study revealed that social health factors, especially financial stress and food insecurity, play a central role in accelerating the biological aging of the heart and increasing the risk of death, surpassing the impact of many traditional medical risk factors.
The study, published in the 'Mayo Clinic Proceedings', highlighted the profound impact of the social and living context on the development of cardiovascular diseases.
With a shift in health care priorities as age advances and with the number of Americans over the age of 65 expected to double to about 82 million by 2050, nearly a quarter of the population, health care systems are increasingly focusing on the concept of healthy aging and quality of life.
In this context, the principal investigator of the study, Dr. Amir Lerman from the Department of Cardiovascular Medicine at Mayo Clinic, explained that this shift prompted researchers to look for new indicators of biological aging that go beyond chronological age, given that traditional risk factors alone cannot explain the significant disparities in heart disease incidence.
Lerman indicated that a significant part of the risk for heart disease might be linked to social factors not typically addressed during medical exams, such as living stress or difficulty accessing food.
He noted that these factors not only contribute to accelerating biological aging but may also open the door to interventions capable of slowing it down or even reversing its course.
A wide-ranging study relying on artificial intelligence, the study included more than 280,000 adult patients who received care at Mayo Clinic between 2018 and 2023. The researchers used a comprehensive questionnaire to assess social determinants of health, covering various aspects such as psychological stress, physical activity, social relationships, housing stability, financial status, food security, transportation needs, nutrition, and education.
To estimate heart age, the team used an advanced ECG algorithm supported by artificial intelligence, enabling them to compare the biological age of the heart with the individual's chronological age.
The "heart age gap" as an early risk indicator and the study revealed that what is known as the "heart age gap" is a crucial indicator for understanding future cardiac risks, referring to the difference between the person's chronological age and the actual biological age of their heart.
When a heart is "older" than its owner, it means its tissues and functions have been affected by stress and early deterioration, directly increasing the likelihood of later developing cardiovascular diseases.
The results demonstrated that AI technologies used in ECG are capable of detecting this gap with high accuracy, through analyzing precise electrical signals that the human eye cannot capture. This technique is non-invasive and does not require complex procedures, but it provides doctors an early window into the biological aging of the heart, enabling the detection of hidden and non-traditional risk factors such as living stress or social factors that might not appear in routine medical exams or traditional analyses.
Financial and food-related stress at the forefront of impact and the analyses showed that the interplay between social determinants of health had the most significant effect on heart aging compared to known clinical risk factors.
It was also found that financial stress and food insecurity were the most strongly associated with accelerated cardiac aging across different groups, both at the general population level and when analyzing results according to sex.
And the factors were not only linked to heart aging but also associated with an increased risk of death in some cases, in ways that exceed the impact of known traditional factors.
Study limitations and future implications and the researchers noted that the results might not apply equally to all population groups, given that the artificial intelligence algorithm was validated within Mayo Clinic, and because most participants were from the non-Hispanic white category.
However, the results underscore the importance of incorporating the social dimension in assessing heart disease risks.
In conclusion of the study, Dr. Lerman emphasized that understanding the real role of social determinants of health enables physicians and policymakers to design more precise community-level preventative interventions, and transition towards patient-centered health care that considers the social and economic conditions that often form the hidden root of heart diseases.
