Be aware of this non-traditional risk factor, say Mayo Clinic experts—one that a majority of Americans admit weighs heavily on their minds.
For decades, doctors have framed the heart health conversation around 10-year heart risk percentages—informing a patient, for instance, that they may have a 15% risk of heart attack within the next 10 years. Today, many medical experts have reframed that risk using “cardiac age“—a number representing how fast the crucial organ seems to be aging, regardless of how many actual years you’ve lived.
Now, a large December 2025 study, conducted by a group of Mayo Clinic cardiologists, points out that the pace of that aging isn’t shaped by biology alone. “Psychosocial determinants”—including your specific worries—can also play a role.
The researchers analyzed health data from more than 280,000 adults who received care at Mayo Clinic sites between 2018 and 2023. Using an artificial intelligence–enhanced electrocardiogram (AI-ECG), the team estimated each person’s “cardiac age,” then compared it with their actual age. The gap between the two offered a window into biological heart aging, as well as future risk.
What stood out most wasn’t cholesterol, blood pressure, or even existing disease—all well-established risk factors for cardiovascular problems. It was people’s daily stressors, which seemed to take an unexpectedly significant toll on long-term heart health.
Participants completed questionnaires about social determinants of health, including education, nutrition, and employment. When researchers modeled how social factors interacted with traditional risk factors, they found that financial strain and subsequent food insecurity were especially influential, linked to hearts that appeared biologically older than expected. According to a recent Capitol One survey, up to 77% of Americans report stressing about their finances—meaning the findings could have widespread implications.
These social pressures didn’t just affect cardiac age—they were also tied to survival. Even after accounting for standard cardiovascular risks, people experiencing financial stress had a markedly higher risk of death during the study’s follow-up period. In statistical models, social determinants outweighed many medical and demographic factors in predicting both heart aging and mortality across men and women.
“Our current research was motivated by the observation that traditional risk factors do not explain and contribute equally to cardiovascular disease,” says Amir Lerman, MD, a senior researcher and director of the Cardiovascular Research Center at the Mayo Clinic in Rochester, Minnesota. “There are social factors that we do not identify or inquire about from our patients that may potentially reverse biological aging,” Dr. Lerman notes in a Mayo Clinic news release.
The findings arrive at a critical moment. With the “Baby Boomers” generation currently in their late 50s to late 70s, healthcare is increasingly focused on “healthy aging”—not just living longer, but preserving function and quality of life. U.S. health experts report that cardiovascular disease remains the leading cause of death, and its burden rises sharply with age. Yet prevention efforts have largely centered on individual behaviors and clinical markers, often overlooking the environments people live and work in.
But this study suggests that, through pairing AI-based tools like ECG-derived cardiac age with deeper attention to social needs, clinicians may be better equipped to identify patients at risk earlier, and intervene more effectively. Ultimately, protecting heart health may require treating not just the heart itself, but the conditions surrounding it.
Says Dr. Lerman: “Identifying the most important risk factors for cardiac aging allows for targeted preventive intervention in the community and empowers physicians to engage in patient-centered care, addressing the social context that contributes to heart disease.”
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