“Biological age” has become the health buzzword of the decade, and people are spending small (and large) fortunes on fancy new scans, testing and supplements all in pursuit of a younger biological age.
Most of us mere mortals, however, cannot afford such regimes, but that doesn’t mean we aren’t interested in the potential, more accessible ways we can both measure our longevity and support it. Cue: cardio age.
What Is Cardio Age?
“Cardiovascular or cardio age is a way of expressing the health of your heart and blood vessels in terms of age,” says Dr Harpal Bains, longevity doctor and Medical Director at Harpal Clinic. “If you have early signs of wear and tear like stiff arteries, high blood pressure or poor fitness, your cardio age could be impacted.”
So, how does it differ from other biological age tests? “Most biological age tests look across multiple systems, for example, epigenetics, telomere length, glycation or inflammation to estimate your overall ageing rate,” explains Dr Bains. While these can help provide a broad, system-wide insight into how your body may be ageing on a cellular or biochemical level, she says that “cardio age brings something more specific and arguably, more urgent, to the table.”
“Cardio age brings something more specific and arguably, more urgent, to the table”
Where cardio age differs is that it focuses entirely on the cardiovascular system, which Dr Bains says is where many of the earliest and most predictive signs of ageing appear. “Because most adults will ultimately face cardiovascular-related disease or decline, cardio age offers a more actionable, real-time measure of longevity risk,” she adds.
Instead of excluding the insights from biological age testing, cardio age can reflect them in real-time, explains Dr Bains. “For example, low-grade inflammation, which might show up on a biological age test, also affects arterial stiffness, endothelial function and vessel wall thickening – all of which are factored into cardio age assessments.”
Cardio age, Dr Bains adds, is also arguably a more accessible metric, as it “has the added benefit of being easier to track and influence, often within weeks or months, using tools you can access at home or in a clinic”.”For many people, this makes cardio age a more immediately empowering measure of progress, something that is much harder and more expensive with biological age tests,” she adds.
Why Does Cardio Age Matter?
But with so many allegedly “must-measure” health metrics popping up on our social media feeds every day, is cardio age just another trending test we needn’t really be concerned with? No, says Dr Bains. “Your cardiovascular system is central to every other system in your body, like the brain, kidneys and all other organs, hormones and cellular energy. It’s one of the earliest systems to show signs of ageing.” However, most changes are often silent, she explains, “so early detection of issues is likely to make the biggest impact over the longer term.”
“A higher-than-expected cardio age can predict higher risk of stroke and heart attack, reduced exercise capacity, cognitive decline and reduced lifespan,” she adds. “The upside is it’s often modifiable and changes can be seen quickly with the right plan.”
READ MORE: The Proven Health Benefits Of Getting Outdoors
What Is Considered A “Nomal” Cardio Age?
“A ‘normal’ cardio age is generally considered to be equal to or slightly younger than your actual age,” says Dr Bains. “Ideally, your cardio age should be around 5 years younger than your chronological age in midlife.”
While men can often have worse cardiovascular profiles earlier on in life, Dr Bains says that women may see a steeper increase post-menopause. “Hormonal changes play an important role here and are a key modifiable factor.”
So, when should you be concerned, and is cardio age reversible? “If your cardio age is 5+ years older than your actual age, it’s worth taking seriously,” says Dr Bains. “Even in the absence of symptoms, an older cardio age indicates underlying vascular dysfunction, which often progresses silently.”
“If your cardio age is 5+ years older than your actual age, it’s worth taking seriously”
However, Dr Bains reassures us that if our cardio age older than our actual age, all is not lost. “Cardio age is one of the most reversible biological metrics,” she says. “Regular movement, tailored nutrition, better sleep and blood pressure control can all improve vascular tone, insulin sensitivity and endothelial function.”
As with most things in life, though, we can’t expect changes overnight. “While some markers like resting heart rate and recovery time can improve within weeks, deeper changes like arterial flexibility or vessel wall health usually take several months of consistent effort – measured by assessing pulse wave velocity or imaging-based scans,” says Dr Bains. “Still, it’s a highly modifiable system if you give it the right inputs.”
However, genetics, hormones and medications – particularly in older individuals – can also play a role, adds Dr Bains, meaning some individuals may require more targeted support.
READ MORE: 8 Simple Strategies To Slow The Ageing Process In Your 60s That You Can Start Any Time
How To Calculate Your Cardio Age At Home
While you can attend clinics to determine your cardio age, it is also a metric that you can measure at home with a few simple tests. Below, Dr Bains has provided the complete method and scoring system to calculate your cardio age at home.
1. Resting heart rate (RHR)
Why it matters: A lower resting heart rate usually means your heart is more efficient and under less stress. In essence, one single, powerful pump can deliver enough blood all over your body and so your heart does not have to pump too many times. A higher rate could indicate poor fitness, overtraining, or chronic stress.
How to check: Count your pulse first thing in the morning for 60 seconds (wrist or neck).
Scoring
- Below 60 bpm: 0 points (excellent)
- 60-70 bpm: 1 point
- 71-80 bpm: 2 points
- Above 80 bpm: 3 points
2. Heart rate recovery (after step test)
Why it matters: The faster your heart rate goes back to normal after exercise, the better your autonomic nervous system is functioning. Poor recovery has been linked to higher cardiac risk.
How to check: Do a steady three-minute step test on a low step (about 20cm), then measure your heart rate right after and again one minute later. The difference = your recovery rate.
Scoring
- Drop of ≥20 bpm in the first minute: 0 points (excellent)
- Drop of 12-19 bpm: 1 point
- Drop of <12 bpm: 2 points
- No drop or rise: 3 points
3. Waist-to-height ratio
Why it matters: Carrying weight around your middle (around your organs) is strongly associated with heart disease and insulin resistance.
How to check: Divide your waist measurement at the belly button (in cm) by your height (in cm).
Scoring
- ≤0.5: 0 points
- 0.51-0.55: 1 point
- 0.56-0.6: 2 points
- >0.6: 3 points
4. Smoking/vaping status
Why it matters: Even light smoking or vaping can accelerate blood vessel damage and inflammation. Past users retain some risk, but quitting brings real benefit.
Scoring
- Never smoked/vaped: 0 points
- Stopped >5 years ago: 1 point
- Stopped in past 5 years: 2 points
- Current smoker/vaper: 3 points
READ MORE: Why Is It So Hard To Quit Vaping? (+ The Exact Steps, Per Experts)
5. Perceived stress level (simple 0-10 scale)
Why it matters: Ongoing stress raises cortisol, blood pressure and inflammation – all of which contribute to vascular ageing.
Rate your average daily stress (0 = calm, 10 = overwhelmed)
- 0-3: 0 points
- 4-6: 1 point
- 7-8: 2 points
- 9-10: 3 points
READ MORE: What Is Oxidative Stress? Causes And How To Reduce It, According To Experts
6. Optional bonus: blood pressure reading (if available)
Why it matters: High blood pressure is often silent but slowly damages the arteries and heart over time as the heart has to work extra hard to pump through pressurised blood vessels.
How to check: Use a reliable home monitor, seated, after five minutes of rest.
- Below 120/80 mmHg: 0 points (optimal)
- 120-129 / <80 mmHg: 1 point (elevated)
- 130-139 / 80–89 mmHg: 2 points (high-normal / Stage 1 hypertension)
- ≥140 / ≥90 mmHg: 3 points (hypertension)
Tip: If systolic and diastolic fall into different ranges, use the higher score.
Total your points (without BP):
- 0-3 points: Cardiovascular system is likely younger than your age.
- 4-7 points: On track – cardio age likely close to actual age.
- 8-12 points: Elevated – cardio age may be 5-10 years older.
- 13-15 points: High – cardio age likely 10+ years older; time to act.
Total your points (with BP):
- 0-4 points: Cardiovascular system is likely younger than your age.
- 5-9 points: On track – cardio age likely close to actual age.
- 10-13 points: Elevated – cardio age may be 5-10 years older.
- 14-18 points: High – cardio age likely 10+ years older; time to act.
“If your home score suggests your cardio age is 10+ years above your real age, it may be time to check in with a clinic,” says Dr Bains. “A comprehensive cardio age assessment with a doctor can include advanced testing, like arterial stiffness, VO2 max and inflammatory markers, to help you understand what’s driving the result and how to reverse it with precision.”
How Quickly Can You Improve Cardio Age?
“Some markers like heart rate variability or recovery can improve within two to four weeks,” says Dr Bains. “Structural changes such as arterial stiffness may take three to 12 months to improve, and in some cases, severely damaged arteries may not fully recover.”
On average, she adds, people will likely be able to reduce their cardio age by 1-10 years within 6-12 months, with consistent effort.
Tips For Reversing Cardio Age
Dr Bains’s top tips for reversing cardio age:
- Add Zone 2 cardio (eg, brisk walking, cycling) three to five times a week.
- Include one to two sessions of resistance training weekly.
- Ensure adequate recovery if you exercise very often, incorporating breathwork and cooldowns, plus rest days.
- Track and improve VO2 max or HRV if possible.
- Cut ultra-processed foods, added sugars and excess alcohol.
- Focus on magnesium, potassium, nitrate-rich foods (eg, leafy greens, beets) and niacin.
- Include omega-3s, dark berries and polyphenols for endothelial support.
- Stay well hydrated if managing blood pressure and take medications if necessary to help control your blood pressure until other changes kick in.
- Get a hormonal assessment, especially after the age of 45 and optimise your hormones where possible.
