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Recent studies have shown that maintaining a heart-healthy lifestyle can positively impact biological aging and reduce the risk of cardiovascular disease and associated mortality. This study focused on DNA methylation as a key mediator in this process. Analysis of data from the Framingham Heart Study found that improving lifestyle factors can significantly reduce cardiovascular risk, especially in individuals genetically predisposed to accelerated aging. These findings highlight the role that lifestyle modification can play in promoting cardiovascular health and longevity.
New research suggests that a higher lifestyle score may positively impact risk factors for heart disease and influence the ageing process of the body and its cells.
New research published Journal of the American Heart Association Studies suggest that adopting a heart-healthy lifestyle may have a positive effect on biological aging, which refers to the age of the body and cells, and therefore on heart health.
“Our findings indicate that engaging in heart-healthy behaviors and managing heart disease risk factors, regardless of chronological age, is associated with younger biological age, lower risk of heart disease and stroke, and lower risk of death from heart disease, stroke, and all-cause mortality,” said Jiantao Ma, PhD, assistant professor in the Department of Nutrition Epidemiology and Data Science at the Friedman School of Nutrition Science and Policy at Tufts University, Boston, and lead author of the study.
The role of DNA methylation in cardiovascular health
In this study, DNA Methylation is a chemical process that controls gene expression and may be how factors related to cardiovascular health influence cellular aging and mortality risk. DNA methylation levels are a key biomarker for assessing biological age, which is primarily determined by genetics but can also be influenced by lifestyle choices and stress.
The researchers looked at health data from 5,682 adults (mean age 56; 56% of participants were women) who took part in the Framingham Heart Study, a large-scale, ongoing, multigenerational research project aimed at identifying risk factors for heart disease. Using interviews, physical exams and laboratory tests, all participants were assessed with the American Heart Association’s Life Essentials 8 tool, which rates eight heart-healthy lifestyle factors important to cardiovascular health on a scale of 0 to 100, with 100 being the best.
The assessment includes four behavioral measures: dietary intake focusing on daily nutritional quality and balance, physical activity to assess frequency and intensity of exercise, sleep duration and sleep length and quality per night to assess sleep duration, and smoking status to identify tobacco exposure. In addition, four clinical measures are used: body mass index (BMI) to measure body fat based on height and weight, cholesterol levels to indicate lipid health, blood glucose levels to assess glucose control, and blood pressure to monitor cardiovascular strain. Each participant was also assessed by four tools that estimate biological age based on DNA methylation (a process that affects gene expression) and a fifth tool that evaluates a person’s genetic propensity for accelerated biological aging. Participants were followed for 11 to 14 years to monitor the development of new cardiovascular disease, cardiovascular-related death, or death from any cause.
The analysis revealed the following:
- For every 13-point increase in an individual’s Life Essentials 8 score, Cardiovascular disease For the first time, deaths from cardiovascular disease fell by 36% and deaths from all causes fell by 29%.
- For participants whose genetic risk profile made them more likely to experience accelerated biological age, the Life’s Essential 8 score could have a significant impact on outcomes via DNA methylation, with DNA methylation reducing the risk of cardiovascular disease, cardiovascular death, and all-cause mortality by 39%, 39%, and 78%, respectively.
- Overall, they estimated that about 20% of the association between Life’s Essential 8 score and cardiovascular disease outcomes was due to the effect of cardiovascular health factors on DNA methylation. In contrast, for participants at high genetic risk, the association was almost 40%.
“There are some commercially available biological age calculators based on DNA methylation, but there are no good recommendations on whether people should know their epigenetic age,” Ma said. “Our message is that everyone should be mindful of the eight health factors for heart disease and stroke: eating healthy foods, being more active, quitting smoking, getting healthy sleep, managing their weight, and maintaining healthy cholesterol, blood sugar and blood pressure levels.”
Effects of DNA methylation and future research directions
Randy Foraker, PhD, MA, FAHA, co-author of “Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health,” said the findings are consistent with previous research.
“We know that modifiable risk factors and DNA methylation are each independently associated with cardiovascular disease. What this study adds is that DNA methylation may act as a mediator between risk factors and cardiovascular disease,” said Foraker, professor of medicine in the Institute of Informatics, Data Science and Biostatistics and director of the Center for Population Health Informatics at Washington University School of Medicine in St. Louis, Mo. “This study sheds light on how cardiovascular health influences biological aging, which has important implications for healthy aging and the prevention of cardiovascular disease and potentially other health conditions.”
Study details, background and design:
- The study analyzed health data from a subgroup of participants in the Framingham Heart Study who were screened between 2005 and 2008, as well as a third-generation group from 2008 to 2011.
- Participants were followed for an average of 14 years for the first participant’s children and 11 years for grandchildren.
- Health outcomes in the analysis included incident cardiovascular disease (coronary heart disease, heart attack, stroke, or heart failure), death from any cardiovascular disease, or death from any cause.
- Results were adjusted for sex, age, and alcohol intake. All-cause mortality outcomes were adjusted for the presence of cancer (excluding nonmelanoma skin cancer) or heart disease at study enrollment. Participants who had already been diagnosed with heart disease at study enrollment were excluded from the analysis of new-onset cardiovascular disease.
- The four tools measuring DNA methylation-based epigenetic age scores are based on established algorithms: DunedinPACE Score, PhenoAge, DNAmTL, and GrimAge. The fifth tool, GrimAge PGS, assessed genetic propensity for accelerated biological aging.
Because this study is an analysis of previously collected health data, it cannot prove a causal relationship between cardiovascular health risk factors and DNA methylation. Additionally, DNA methylation measurements were taken from a single time point, limiting the validity of mediation effects. The findings of this study are also limited because participants were primarily of European descent, and the interactions between Life’s Essential 8 and genetic aging found in this study may not be generalizable to people of other races and ethnicities.
“We are now expanding our study to include people from other racial and ethnic groups to further explore the relationship between cardiovascular risk factors and DNA methylation,” Ma said.
According to the American Heart Association’s 2024 Heart Disease and Stroke Statistics, in 2021, heart disease and stroke killed more people in the United States than all types of cancer and chronic lower respiratory tract diseases combined, and caused approximately 19.91 million deaths worldwide.
Reference: “Epigenetic age mediates the association between essential factor of life 8 and cardiovascular disease and mortality” Madeleine Carbonneau, Yi Li, Brenton Prescott, Chunyu Liu, Tianxiao Huang, Robbie Joh-Haynes, Joan M. Murabito, Nancy L. Hurd Costa, Vanessa Zantakis, Daniel Levy, Jiangtao Ma, 29 May 2024, Journal of the American Heart Association.
DOI: 10.1161/JAHA.123.032743
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