{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:31:31Z","timestamp":1790883091537,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Individuals with cardiovascular\u2010kidney\u2010metabolic (CKM) syndrome face an elevated risk of stroke, yet effective risk stratification indicators remain limited. This prospective study aims to investigate the associations of biological age acceleration (BioAge\u2010gap) and heart age acceleration (HeartAge\u2010gap) with new\u2010onset stroke in individuals with CKM syndrome Stages 0\u20133, utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2015 and 2020. Baseline BioAge\u2010gap and HeartAge\u2010gap were calculated via the Klemera\u2013Doubal method (KDM) and Framingham risk score (FRS), respectively. The primary outcome was self\u2010reported physician\u2010diagnosed stroke identified during the 2018 and 2020 follow\u2010ups. Analysis of 7283 eligible participants aged 45\u201375 years revealed a positive association between BioAge\u2010gap and new\u2010onset stroke (odds ratio [OR] = 1.05,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.01). Furthermore, compared to participants with a non\u2010positive HeartAge\u2010gap, those with HeartAge\u2010gaps of 0\u20135 years and \u22655 years exhibited significantly increased risks of stroke by 74% and 141%, respectively. Subgroup analyses and interaction tests identified a significant gender interaction in the association between HeartAge\u2010gap and stroke, indicating that men with accelerated heart age represent a vulnerable subgroup. Restricted cubic splines (RCSs) confirmed a linear association, and sensitivity analyses validated the robustness of these findings. Integrating these intuitive indicators into clinical practice could facilitate primary stroke prevention and mitigate CKM syndrome progression.\n                  <\/jats:p>","DOI":"10.1111\/jch.70256","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T07:18:24Z","timestamp":1776669504000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Associations of Biological Age and Heart Age Accelerations With New\u2010Onset Stroke in Individuals With Cardiovascular\u2010Kidney\u2010Metabolic Syndrome Stages 0\u20133: Evidence From a Chinese Longitudinal Study"],"prefix":"10.1111","volume":"28","author":[{"given":"Hao","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Lui","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"He","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sports Beijing Normal University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center of Community\u2010Based Health Research Fudan University  Shanghai China"},{"name":"Department of Neurology Shanghai Fifth People's Hospital  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Jin","sequence":"additional","affiliation":[{"name":"Center of Community\u2010Based Health Research Fudan University  Shanghai China"},{"name":"Department of Neurology Shanghai Fifth People's Hospital  Shanghai 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