Year: 2025
Type: article
Abstract: Background Cardiovascular ageing is the main driver of chronic cardiovascular diseases, offering a unique opportunity to transform research and prevention. We aimed to develop and validate a novel estimate of cardiovascular biological age (HeartAge), and its deviation from chronological age (HeartAge-gap), using supervised machine-learning model informed by readily extractable cardiovascular-magnetic-resonance phenotypes. Methods HeartAge and HeartAge-gap were estimated in 31 784 UK-Biobank participants (16 640 females, 64 ± 7 years). A positive HeartAge-gap indicates an older cardiovascular system, conversely a negative HeartAge-gap indicates a younger one. Logistic regression assessed association between HeartAge-gap and prevalent cardiovascular conditions, while Cox regression proportional hazard-ratio models evaluated its predictive value for the composite cardiovascular outcome and all-cause mortality. External validation was conducted in 897 participants (472 females, 60 ± 10 years) from the Multi-Ethnic-Study-of-Atherosclerosis (MESA). Results HeartAge-gap was independently associated with hypertension, diabetes, and ischaemic heart disease in both sexes (P < 0.05 for all). Over a median follow-up of nearly 6 years, an increased HeartAge-gap predicted the composite cardiovascular outcome in females (HR: 1.022, 95% CI:1.001–1.044, P = 0.048) and males (HR: 1.017, 95%CI: 1.002–1.033, P = 0.027) independently of chronological age and other major confounders including, body-mass-index, ischaemic-heart-disease, diabetes, and hypertension. In females, an increased HeartAge-gap also predicted all-cause mortality (HR: 1.061, 95%CI: 1.007–1.118, P = 0.027) regardless of chronological age. In MESA females, increased HeartAge-gap predicted the cardiovascular outcome (HR: 1.113, 95%CI: 1.025–1.210, P = 0.011) independently of chronological age and other key confounders. Interpretation A biologically older cardiovascular system emerged as a robust, independent predictor of adverse cardiovascular outcome. In females advanced cardiovascular ageing also predicted all-cause mortality regardless of chronological age.
Source: Postgraduate Medical Journal
Author: Ageel Mohamed
Institution: King's College London
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4414094087