Journal of clinical hypertension (Greenwich, Conn.)···
Faster Biological and Heart Aging Linked to New Stroke Risk in People with Early to Mid-Stage Heart, Kidney, and Metabolic Problems: Findings from a Chinese Long-Term Study
Accelerated biological age and heart age were associated with higher new-onset stroke risk among middle-aged and older Chinese adults with stages 0-3.
Evidence
This prospective CHARLS analysis followed 7283 adults aged 45-75 from 2015 to 2020 and assessed self-reported physician-diagnosed stroke at 2018 and 2020 follow-ups.
Caveat
The outcome was self-reported physician-diagnosed stroke, and the observational design supports risk stratification associations rather than causal proof.
Simplified
Individuals with cardiovascular-kidney-metabolic (CKM) syndrome face an elevated risk of stroke, yet effective risk stratification indicators remain limited. This prospective study aims to investigate the associations of biological age acceleration () and heart age acceleration () with new-onset stroke in individuals with Stages 0-3, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2015 and 2020. Baseline BioAge-gap and HeartAge-gap were calculated via the Klemera-Doubal method (KDM) and Framingham risk score (FRS), respectively. The primary outcome was self-reported physician-diagnosed stroke identified during the 2018 and 2020 follow-ups. Analysis of 7283 eligible participants aged 45-75 years revealed a positive association between BioAge-gap and new-onset stroke (odds ratio [OR] = 1.05, p < 0.01). Furthermore, compared to participants with a non-positive HeartAge-gap, those with HeartAge-gaps of 0-5 years and ≥5 years exhibited significantly increased risks of stroke by 74% and 141%, respectively. Subgroup analyses and interaction tests identified a significant gender interaction in the association between HeartAge-gap and stroke, indicating that men with accelerated heart age represent a vulnerable subgroup. Restricted cubic splines (RCSs) confirmed a linear association, and sensitivity analyses validated the robustness of these findings. Integrating these intuitive indicators into clinical practice could facilitate primary stroke prevention and mitigate CKM syndrome progression.
Key numbers
1.05
Increase in Stroke Risk per Unit
Odds Ratio for in final model
1.74
Stroke Risk Increase for 0-5 Years
Odds Ratio for 0-5 years
2.41
Stroke Risk Increase for ≥5 Years
Odds Ratio for ≥5 years
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