The Young at Heart Live Longer
Excerpt by Amanda Gardner, HealthDay

A famous old phrase has it that a "man is as old as his arteries."

New research from the University of Pittsburgh suggests men (and women) could also be as young as their arteries. Measuring and treating extremely low levels of cardiovascular disease, levels that don't yet show any symptoms, can extend life spans significantly.

"Within people who look healthy there's this huge range of risk factors and subclinical disease, and it shouldn't just be accepted as average; it should probably be treated more aggressively," says Dr. Anne B. Newman, lead author of a study appearing in this week's issue of the Archives of Internal Medicine. "The tendency is to say, 'Well, you got this far, there's not much else we can do. You're average for your age.' If we change our goal to what's optimal, I think that we could really extend that healthy period a lot longer in older people."

At the beginning of the study, 2,932 men and women over the age of 65 were deemed perfectly healthy by normal standards. In other words, they were free of cardiovascular disease, cancer, chronic obstructive pulmonary disease and their physical and cognitive functioning were fine. All participants underwent a number of tests, including a carotid ultra sonogram, an ankle-arm index and an electrocardiogram to detect subclinicalcardiovascular disease.

After eight years of observation, it was clear those who had entered the study free of subclinical cardiovascular disease did better than those who had not.

On average, participants with subclinical cardiovascular disease had the health of individuals five years older without subclinical disease. Individuals aged 65 to 69 without subclinical disease averaged 15 to 16 additional years of health, those aged 85 and older could expect four to five additional years. Men and women with subclinical disease, on the other hand, averaged only one to two additional years of good health for both age groups.

"When we detailed all cardiovascular risk factors, we found a huge range in people's remaining active life expectancy," Newman says. "This is not just some fountain-of-youth thing. We were able to predict [the active life of] a man or a woman who came into the study entirely healthy and functional on the basis of these subclinical markers of disease."

Practically speaking, what does this mean? For one thing, it may be a reason to use two of the measures employed in the study, the carotid ultra sonogram and the ankle-arm index, more frequently.

"This is giving justification to these two simple, noninvasive, non-painful tests," says Dr. Stephen Siegel, a clinical assistant professor of cardiology at New York University School of Medicine in New York City.

There may also be reason to more aggressively use other interventions such as quitting smoking, lowering lipids, treating blood pressure and dieting and exercising.

One question that wasn't answered in the study is whether people as young as 40 or 50 would benefit from additional interventions.

And another thing to bear in mind is that observational studies such as this one "enable us to see a pattern but don't necessarily show us a causal relationship between subclinical vascular diseases and lack of successful aging," Siegel says. "There could be another factor that causes both of them." That question will have to be answered by future studies.

Nevertheless, adds Siegel, "we're beginning to see an approach towards being more aggressive with advanced geriatric patients. That part of [the study] was nice."

More information

For more on aging, visit the National Institute on Aging. The American Heart Association has more on cardiovascular disease.

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