An adage of clinical wisdom posits that a person’s true age is determined by the health of their arteries and muscles, not by the number of years they have lived.In this issue of the European Heart Journal, He et al. report their comprehensive post hoc analysis of three prospective ageing cohorts (CHARLS from China, ELSA from the UK, and HRS from the USA).1 The population studied consisted of community-dwelling older adults without known cardiovascular disease (CVD) at baseline, amounting to a pooled sample size of 19 685 with an average age of 62 years. The predictor variable was frailty as measured by a 28-item frailty index (FI), which was categorized as robust (FI ≤0.10), pre-frail (FI 0.11–0.24), or frail (FI ≥0.25).