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Accelerated biological aging and incident degenerative valvular heart disease: Findings from 408,783 UK Biobank
Chaoyang Lin1,2, Enhao Wei2,3, Qianyao Lai1,2
1Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou 350001, PR China.
Insights
Accelerated biological aging increases the risk of degenerative valvular heart disease (VHD) and related adverse events in middle-aged adults. These findings suggest biological age acceleration (BAA) can aid in early risk stratification for VHD.
Area of Science:
- Cardiology
- Gerontology
- Genetics
Background:
- Prior studies suggest a link between frailty, accelerated biological aging, and aortic stenosis.
- Comprehensive evidence on biological age acceleration (BAA) across degenerative valvular heart diseases (VHD) in middle-aged adults is limited.
Purpose of the Study:
- To investigate the association between BAA and the risk of incident degenerative VHD and related clinical events in a large middle-aged cohort.
- To evaluate the utility of BAA measures, PhenoAge and Klemera-Doubal method Biological Age (KDM-BA), in predicting VHD outcomes.
Main Methods:
- Analysis of 408,783 UK Biobank participants without baseline VHD.
- Calculation of BAA using PhenoAge and KDM-BA algorithms based on clinical traits.
- Assessment of incident aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), and associated events or mortality over a median follow-up of 13.9 years.
Main Results:
- Elevated BAA was significantly associated with increased risk of AS and AS-related events.
- Higher quartiles of PhenoAge and KDM-BA showed significantly higher incidence rates and hazard ratios for AS.
- Significant associations were also observed for AR and AR-related events, but not for MR-related events.
Conclusions:
- Biological age acceleration is linked to increased risks of degenerative VHD (AS, AR) and related adverse events in middle-aged adults.
- BAA metrics demonstrate potential as tools for early risk stratification and targeted prevention strategies for VHD.
- Further research may elucidate the specific mechanisms underlying BAA's impact on different VHD types.
Background:
Although prior studies have linked frailty and accelerated biological aging to aortic stenosis, comprehensive evidence across the spectrum of degenerative valvular diseases (VHD) and related clinical events remains unclear in middle-aged adults.
Methods:
We analyzed 408,783 UK Biobank participants free of baseline valvular disease. Biological age accelerations (BAA) measures were derived from clinical traits using Phenotypic Age (PhenoAge) algorithm and the Klemera-Doubal method Biological Age (KDM-BA). Outcomes included incident aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), and related interventions or mortality.
Results:
Over a median follow-up of 13.9 years, 10,364 incident degenerative VHD events (2.5 %) were documented, comprising 4602 AS, 1678 AS-related events, 1639 AR, and 4903 MR cases. Elevated BAA was significantly associated with higher AS risk. For PhenoAge, adjusted AS incidence rates (per 10,000 person-years; 95 % confidence interval) across quartiles (Q1-Q4) were 3.73 (3.37-4.12), 4.44 (4.05-4.88), 5.11 (4.67-5.59), and 7.79 (7.18-8.46), yielding an adjusted hazard ratio (HR) of 2.15 (1.96-2.35) for Q4. Comparable trends were observed for KDM-BA, with an adjusted HR of 1.98 (1.83-2.15) for Q4 vs Q1. AS-related events followed a similar pattern, with HRs of 1.80 (1.55-2.09) for PhenoAge Q4 and 2.22 (1.94-2.54) for KDM-BA Q4. Significant associations were also found for AR, AR-related events, and MR, but not for MR-related events.
Conclusions:
Among middle-aged adults, both BAA metrics were associated with increased risks of degenerative VHD and related adverse events, except for MR-related events. These findings highlight BAA as a potential tool for early risk stratification and targeted prevention.
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