Hi ,

How has your day been so far? I want to share something today that might make you look at your heart and brain health differently—your heart age.

You go to the doctor for your annual health check-up. Your weight is measured, your blood pressure is checked—hopefully correctly—and your labs and family history are reviewed. At the end, your doctor says, “Based on this information, your risk of having a heart attack or stroke in the next 10 years is 10%.”

Most heart disease and stroke risk calculators, such as the Framingham Risk Score, include age, sex, blood pressure, cholesterol levels, diabetes status, smoking history, and alcohol intake, and calculate the percentage risk over a specified time period.

But here is the problem: many people hear “10% risk” and think, “So I’m 90% safe.” The number doesn’t feel urgent. It doesn’t always lead to action.

That’s why another tool—called Heart Age—was developed. Instead of giving a percentage, it tells you how "old" your heart is compared to a healthy person of the same age and sex.

For example, a 45-year-old man may find out that his heart age is 55. Now that grabs his attention. No one wants any body part to be older than the number of birthdays they've had.

Studies show that people remember their heart age more accurately than risk percentages. The next obvious question to ask would be "What can I do to reduce my heart age?"

Yet knowing your heart age alone rarely leads to lasting behaviour change.

Most of us already know that we should eat better, exercise more, sleep well, manage stress, lose weight and keep it off and limit our alcohol consumption. The real challenge is not knowledge but having the right tools for sustainable long-term health behaviour change. Long-term success requires long-term strategies.

Limitations of risk calculators:

There are multiple risk calculators (Links below), and none is perfect.

1. Framingham Risk Score—based on people of predominantly European ancestry.

2. The new PREVENT calculator—includes kidney function tests—that's good. (and Social Deprivation Index based on US ZIP code—so it is not applicable outside the US)

3. UK Heart Age uses the QRISK score, which includes different ethnicities (South Asians have higher risks at a younger age) and autoimmune conditions like Rheumatoid Arthritis.

Most of the calculators include total cholesterol and HDL. We know that total cholesterol levels can increase with acute infections, such as when you are tested while having the flu. High HDL is not always protective.

None of the calculators uses markers of chronic inflammation, such as Hs-CRP, although QRISK includes rheumatoid arthritis.

None of the risk calculators include women's reproductive risks like pregnancy hypertension, pregnancy diabetes or early menopause.

Despite the shortcomings of these risk calculators, we use them as a baseline for comparison. Good as conversation starters, but these don't provide individualized risk.

So where should you start?

Check your basic risks and do a basic self-assessment based on the following:

1. Sleep

2. Food

3. Movement

4. Prescription medications

5. Supplements

How do you score on these?

Where would you like to start?

(By the way, no one can score 100% every day).

In my next email, I will share details of my upcoming Tiny Habits for Better Blood Pressure program, a structured approach to help you make and sustain the changes that matter most for your heart and overall well-being. You can join even if you do not have hypertension. This will be a paid program, designed to be accessible while offering the kind of support and follow-up needed for real, lasting results.

Until then, I wish you younger hearts and brains :-)!

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Dr. Shabnam Das Kar, MD

Functional Medicine Doctor

Tiny Habits Coach

Email: info@drkarmd.com

1. What is your heart age (UK)?
2. Framingham Risk Score (Canadian units. Includes heart age)
3. PREVENT Calculator