The role of aging biology as a novel risk factor and biomarker for vascular outcomes in different accessible body tissues such as saliva and blood remain unclear. We aimed to (1) assess the role of aging biology as a risk factor of stroke and heart disease among individuals of same chronologic age and sex and (2) compare aging biology biomarkers measured in different accessible body tissues as novel biomarkers for stroke and heart disease in older adults.

This study included individuals who consented for blood and saliva draw in the Venous Blood Substudy and Telomere Length Study of the Health and Retirement Study (HRS). The HRS is a population-based, nationally representative longitudinal survey of individuals aged 50 years and older in the United States. Saliva-based measures included telomere length. Blood-based measures included DNA methylation and physiology biomarkers. Propensity scores–matched analyses and Cox regression models were conducted.

This study included individuals aged 50 years and older, who consented for blood (N = 9,934) and saliva (N = 5,808) draw in the HRS. Blood-based biomarkers of aging biology showed strong associations with incident stroke as follows: compared with the lowest tertile of blood-based biomarkers of aging, biologically older individuals had significantly higher risk of stroke based on DNA methylation Grim Age clock (adjusted hazard ratio [aHR] = 2.64, 95% CI 1.90–3.66, p < 0.001) and Physiology-based Phenotypic Age clock (aHR = 1.75, 95% CI 1.27–2.42, p < 0.001). In secondary analysis, biologically older individuals had increased risk of heart disease as follows: DNA methylation Grim Age clock (aHR = 1.77, 95% CI 1.49–2.11, p < 0.001) and Physiology-based Phenotypic Age clock (aHR = 1.61, 95% CI 1.36–1.90, p < 0.001).

Compared with saliva-based telomere length, blood-based aging physiology and some DNA methylation biomarkers are strongly associated with vascular disorders including stroke and are more precise and sensitive biomarkers of aging. Saliva-based telomere length and blood-based DNA methylation and physiology biomarkers likely represent different aspects of biological aging and accordingly vary in their precision as novel biomarkers for optimal vascular health.

衰老生物学作为唾液和血液等不同可及身体组织中血管结果的新危险因素和生物标志物的作用仍不清楚。我们的目的是（1）评估衰老生物学作为相同年龄和性别的个体中风和心脏病危险因素的作用，以及（2）比较在不同可触及的身体组织中测量的衰老生物学生物标志物作为中风和心脏病的新型生物标志物老年人的疾病。

这项研究包括同意在健康与退休研究 (HRS) 的静脉血亚组研究和端粒长度研究中抽取血液和唾液的个体。HRS 是一项以人口为基础、具有全国代表性的纵向调查，对象为美国 50 岁及以上的个人。基于唾液的测量包括端粒长度。基于血液的测量包括 DNA 甲基化和生理生物标志物。进行了倾向评分匹配分析和 Cox 回归模型。

这项研究包括 50 岁及以上的个体，他们同意在 HRS 中抽取血液（N = 9,934）和唾液（N = 5,808）。衰老生物学的血液生物标志物与中风事件密切相关，如下所示：与衰老的血液生物标志物的最低三分位数相比，基于DNA甲基化严峻年龄时钟（调整后的风险比[ aHR] = 2.64，95% CI 1.90–3.66，p < 0.001）和基于生理学的表型年龄时钟（aHR = 1.75，95% CI 1.27–2.42，p < 0.001）。在二次分析中，生理年龄较大的个体患心脏病的风险增加如下：DNA甲基化严峻年龄时钟（aHR = 1.77，95% CI 1.49–2.11，p < 0.001）和基于生理学的表型年龄时钟（aHR = 1.61，95） % CI 1.36–1.90，p < 0.001）。

与基于唾液的端粒长度相比，基于血液的衰老生理学和一些DNA甲基化生物标志物与包括中风在内的血管疾病密切相关，是更精确和敏感的衰老生物标志物。基于唾液的端粒长度和基于血液的 DNA 甲基化和生理生物标志物可能代表生物衰老的不同方面，因此作为最佳血管健康的新型生物标志物，其精确度也有所不同。