Abstract 13528: A Comparison of Five Measures of Accelerated Biological Aging and Their Association With Incident Cardiovascular Disease: The CARDIA Study

Abstract

Background: Accelerated biological aging is an increasingly popular way to track the effects of chronic stress over time. Biological aging is linked to external and internal chronic stressors and has the potential to be used clinically to understand a person’s personalized functioning and to predict future disease. Aims: The primary aim was to investigate the similarities and differences in the association of different measures of biological aging and incident cardiovascular disease (CVD). Hypotheses: Our novel predictor, Clinical Marker-Derived Age Acceleration (CAA), and the Framingham Risk Score (FRS) will be most robustly associated with incident CVD, and the associations will be stronger among Black participants. The latter is based on previous findings that Black participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study have, on average, more adverse social determinants of health. Methods: We used Multiple Informants Models (MIM) to compare the strength of five measures of accelerated aging (Intrinsic and Extrinsic Epigenetic Age Acceleration, GrimAge Acceleration, PhenoAge Acceleration, CAA (including clinical biomarkers, e.g., CRP, lung function, glucose, etc.), and one established clinical predictor of future CVD, FRS, to predict incident CVD over 11 years (2007 – 2018). Participants were 913 Black or White individuals examined by CARDIA in 2005-2006, when their mean age was 45 years. We also included race-specific analysis. Measures were standardized (M = 0, SD=1) to facilitate comparison. Results: The incidence rate of CVD within our sample was 7.8 per 1,000 person years and the prevalence of CVD was 7.5%. CAA and FRS significantly predicted incident CVD in the fully adjusted model (OR = 1.31, 95% CI: 1.06 – 1.63) and (OR = 1.28, 95% CI: 1.05 – 1.56), respectively. CAA and FRS were the best predictors of CVD, but there was no significant difference in the predictive value of CAA and FRS (Chi2 = 0.05, p = 0.828). In race-stratified models, CAA was the strongest and most consistent predictor in the Black-only models. Conclusions: Our findings support the association of CAA, a multi-system clinical composite, with incident CVD. Further, this composite may account for some of the well-known racial variation in incident CVD.