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Associations of Biological Age and Heart Age Accelerations With New-Onset Stroke in Individuals With

Hao Zhu1, Hannah Lui1, Li He2

  • 1Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

Journal of Clinical Hypertension (Greenwich, Conn.)
|April 20, 2026
PubMed

Insights

Biological age acceleration and heart age acceleration are linked to increased stroke risk in individuals with cardiovascular-kidney-metabolic (CKM) syndrome. Men with accelerated heart age are particularly vulnerable, highlighting potential new risk stratification tools.

Area of Science:

  • Cardiovascular Medicine
  • Gerontology
  • Public Health

Background:

  • Cardiovascular-kidney-metabolic (CKM) syndrome presents a significant stroke risk.
  • Current risk stratification indicators for stroke in CKM syndrome are limited.
  • Biological age and heart age acceleration are emerging markers of physiological aging.

Purpose of the Study:

  • To investigate the association between biological age acceleration (BioAge-gap) and heart age acceleration (HeartAge-gap) with new-onset stroke in CKM syndrome.
  • To identify effective risk stratification indicators for stroke prevention in CKM syndrome patients.
  • To explore potential gender-specific differences in stroke risk related to accelerated aging.

Main Methods:

  • Prospective cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS) (2015-2020).
  • Calculation of BioAge-gap using the Klemera-Doubal method and HeartAge-gap using the Framingham risk score.
  • Analysis of 7283 participants (aged 45-75) with physician-diagnosed stroke as the primary outcome.

Main Results:

  • Biological age acceleration (BioAge-gap) was positively associated with new-onset stroke (OR = 1.05, p < 0.01).
  • Accelerated heart age (HeartAge-gap ≥ 0 years) significantly increased stroke risk (74% for 0-5 years, 141% for ≥5 years).
  • A significant gender interaction was observed, with men showing higher vulnerability to stroke with accelerated heart age.

Conclusions:

  • Biological age acceleration and heart age acceleration are significant predictors of new-onset stroke in individuals with CKM syndrome.
  • These intuitive aging metrics can enhance stroke risk stratification and primary prevention strategies.
  • Targeted interventions for men with accelerated heart age may be crucial for mitigating stroke risk in CKM syndrome.

Keywords:
biological age accelerationcardiovascular‐kidney‐metabolic syndromeheart age accelerationlongitudinal studynew‐onset stroke

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