You may already be familiar with traditional cardiology, which focuses on treating heart disease using medications, procedures, and lifestyle changes. While this remains essential, a cutting edge area of science is emerging that could transform how we think about prevention and longevity. It is called Geroscience and it is reshaping the way we understand heart health.
So, what exactly is Geroscience?
Think of traditional medicine as addressing the “what” — what condition you have, what symptoms you feel. Geroscience, in contrast, investigates the “why.” Why do we become more vulnerable to heart disease as we age? Why do some people remain healthy into their 90s, while others develop heart issues decades earlier?
Geroscience is the study of how aging itself contributes to chronic conditions like heart disease. Rather than viewing heart disease as a separate problem, it looks at aging as the underlying process that sets the stage for many health issues.
How Can Geroscience Influence Heart Health?
By exploring the biological mechanisms of aging such as cellular inflammation, mitochondrial decline, oxidative stress, and changes in gene expression, researchers are gaining insights into how these changes increase cardiovascular risk. The goal is to intervene earlier and more effectively, often before symptoms appear.
- Intercepting Disease Before It Starts: Geroscience explores early biological signs of aging, well before traditional risk factors become apparent. By targeting these signs early, the hope is to prevent heart disease from developing at all.
- Personalised and Preventive Care: Rather than applying the same approach to everyone, geroscience considers your individual biology — your metabolic health, inflammation levels, and even your sleep patterns — to tailor lifestyle interventions that promote long term cardiovascular resilience.
- Reducing Dependence on Medication: While medications are often necessary, geroscience based strategies may reduce the need for them in some cases by addressing the root causes of disease more proactively.
The Tools of Geroscience: More Than Just Tests
Although still evolving, this field emphasises a comprehensive view of health that includes:
- Nutrition tailored to your unique physiology
- Exercise regimens that support cardiovascular and cellular health
- Stress management techniques to reduce chronic inflammation
- Optimised sleep to enhance repair processes
- Emerging biomarkers to track your personal “biological age”
Geroscience and Cardiovascular Disease: A Deeper Connection
Cardiovascular disease remains one of the most common and serious health challenges globally. While traditional risk factors like cholesterol, blood pressure, and smoking are important, geroscience shifts the focus upstream — to the biological processes of aging that drive these risks in the first place.
As we grow older, changes occur in the heart and blood vessels that increase the chance of disease. Arteries become stiffer, the inner lining of blood vessels becomes less responsive, and repair mechanisms become less efficient. These shifts contribute to:
- Atherosclerosis — plaque formation in the arteries
- Hypertension — driven by vascular stiffness and altered regulation
- Heart failure — due to impaired energy production and structural stress
- Atrial fibrillation — from age related electrical and fibrotic changes in heart tissue
But geroscience is not just about older age or geriatric care. It focuses on the biology of aging that begins to influence health across adulthood, often decades before disease is diagnosed. The goal is to identify and respond to these changes early — while intervention is most effective.
The Inflammation Connection: What hs-CRP and Other Markers Reveal
One of the most active areas of geroscience research involves chronic low level inflammation, sometimes referred to as “inflammaging.” This persistent immune activation damages tissues over time, including the blood vessels that supply the heart.
A key biomarker for this is high-sensitivity C-reactive protein (hs-CRP):
- hs-CRP detects low grade inflammation not picked up by standard tests
- Higher hs-CRP levels are associated with increased cardiovascular risk
- It can help guide decisions, especially for individuals with intermediate risk profiles
Additional biomarkers under investigation include:
- Interleukin-6 (IL-6) and TNF-alpha — indicators of immune system activation
- GlycA — a composite measure of chronic inflammation
- Soluble CD14 and CD163 — linked to vascular instability and immune stress
- Myeloperoxidase (MPO) and LP-PLA2 — involved in oxidative vascular damage
These emerging tools may allow for earlier, more accurate identification of cardiovascular aging and risk, long before symptoms appear.
Geroscience in Practice: Earlier, More Targeted Prevention
The promise of geroscience lies in its potential to personalise heart care by addressing biological age — how well your body is functioning, regardless of how old you are in years. This allows for:
- Earlier detection of subtle but meaningful changes
- Proactive lifestyle interventions that promote cellular resilience
- Delayed progression of disease through better preservation of cardiovascular health
- Reducing long term reliance on medication by treating root causes earlier
Conclusion
Geroscience represents a bold and forward looking shift in how we approach health and disease. Rather than reacting to illness after it appears, this science asks how we can understand and modify the processes of aging that quietly drive disease from within.
At its core, geroscience reminds us that prevention is not just possible, it is powerful. By identifying and addressing early biological changes, we can delay or even prevent the onset of multiple chronic conditions, including heart disease. This has profound implications not only for how we care for individuals, but also for how we think about health, aging, and quality of life across the lifespan.
For cardiovascular health in particular, the potential impact is significant. Instead of waiting for a diagnosis of high blood pressure, angina, or heart failure, we can act earlier — detecting hidden inflammation, metabolic changes, or vascular decline before symptoms appear. Acting at this stage may mean fewer medications, fewer hospital stays, and more years lived with strength and independence.
But the influence of geroscience goes beyond the heart. It touches all aspects of wellbeing — from brain health and immune resilience to bone strength and emotional balance. It offers a unified approach to prevention, grounded in the biology we all share.
As this field continues to evolve, one thing is clear: our future health will be shaped not just by what we treat, but by how early we choose to act. Geroscience offers us the opportunity to act sooner, with greater precision and a more personal focus — and that is the kind of progress that truly matters.
A/Prof Nagesh Anavekar is a cardiologist specialising in general and cardiac imaging, with a strong interest in holistic heart health and wellbeing. He is particularly engaged in the field of geroscience, which explores how the biological processes of aging influence health across the adult lifespan. His work focuses on applying this science to improve early detection and prevention of cardiovascular disease by addressing the biological age of tissues and systems, rather than relying solely on chronological age.
A/Prof Anavekar completed his postdoctoral training at Harvard Medical School and Brigham and Women’s Hospital. He currently serves as Head of Cardiac Imaging at Northern Health and holds an academic appointment with the University of Melbourne. He is an active clinical trialist and widely published in leading journals, including the New England Journal of Medicine.
