Abstract
While aging is a well-established contributor to cardiovascular disease, the specific relation between biological aging-as assessed by PhenoAge and PhenoAge acceleration-and the risk of coronary heart disease (CHD) requires further evidence to elucidate. This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES), alongside both cross-sectional and prospective analyses using data from the UK Biobank, to investigate the association between biological aging and CHD risk across two large cohorts. The results indicated that each unit increase in PhenoAge and PhenoAge acceleration was significantly associated with a higher risk of CHD. Compared to individuals without accelerated aging, those experiencing accelerated aging face a significantly higher risk. These findings suggest that PhenoAge and its acceleration are significant risk factors for CHD development. Moreover, surrogate markers of biological aging may serve as valuable tools for both the primary and secondary prevention of CHD.