Biological Age as a Predictor of Arterial Stiffness in Young and Early Midlife Black and White Women

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BACKGROUND: Chronological age (CA) is independently associated with arterial stiffness, but it is not a sufficient measure of aging or the disparities related to disease risk. While biological age (BA) is considered a more accurate indicator of disease risk, the relationships among BA, CA, and arterial stiffness remain inconclusive. METHODS: In 222 women (n = 143 White, n = 79 Black) enrolled in the Predictive Health Institute cohort (age range 25-49), arterial stiffness was assessed using carotid-femoral pulse wave velocity (cfPWV), measured by applanation tonometry (SphygmoCor). BA was estimated using the Klemera-Doubal method from 11 different clinical biomarkers and CA. Accelerated age (AccA) was calculated as the difference between BA and CA. Overall and race-specific associations between BA and arterial stiffness adjusting for sociodemographics, health behaviors, and clinical factors were estimated using multiple linear regression. RESULTS: Mean (SD) CA was 41.4 (6.3) years in Black women and 39.8 (6.0) years in White women, respectively. Mean (SD) BA, AccA, and cfPWV were 43 (13.1) and 1.6 (12.9) years, and 7.3 (1.1) m/s in Black women and 36 (10.8) and -3.2 (10.6) years, and 6.3 (0.8) m/s in White women (Black-White difference in BA: 6.4 years, P = <0.001). Higher BA was associated with a 0.015 m/s per year (95% CI: 0.002, 0.029, P = 0.028) higher cfPWV after adjustment for demographic and CVD risk factors, without evidence of an interaction by race (P = 0.65). CONCLUSIONS: BA was associated with arterial stiffness in the fully adjusted model. Targeting modifiable risk factors may promote healthy vascular aging and reduce subclinical CVD progression.

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