Association of Vascular Age and Subclinical Target Organ Damage in a Beijing Community-Based Population: A Cross-Sectional Study

BACKGROUND: Vascular aging (VA) reflects arterial biological aging and is closely linked to cardiovascular risk. Carotid-femoral pulse wave velocity (cfPWV) is the gold standard for assessing arterial stiffness and VA. However, evidence is limited on cfPWV-derived vascular age and its association with subclinical target organ damage (TOD) in the general population. This study evaluated whether Δ-age (vascular age minus chronological age) could identify individuals at higher risk of early vascular injury in a Chinese community cohort. METHODS: This cross-sectional study included participants from two Beijing communities. Δ-age was calculated as cfPWV-derived vascular age minus chronological age. Participants were categorized as supernormal vascular aging (SUPERNOVA, <10th percentile), normal VA, and early vascular aging (EVA, 90th percentile). TOD included mean and maximum carotid intima-media thickness (CIMT), and carotid plaque. Associations between Δ-age and TOD were analyzed using multivariable regression models adjusted for conventional cardiovascular risk factors and cfPWV. RESULTS: A total of 6305 participants (mean age 62.5 ± 7.8 years; 34.2% male) were included. Higher Δ-age was associated with increased mean and maximum CIMT and higher carotid plaque prevalence, independent of cfPWV. EVA participants had a higher risk, whereas SUPERNOVA participants had a lower risk of TOD compared with normal VA. After cfPWV adjustment, EVA remained associated with increased mean CIMT and carotid plaque, while SUPERNOVA showed a nonsignificant trend toward a lower risk. Associations were consistent across subgroups. CONCLUSIONS: Δ-age, independent of cfPWV, was an independent risk factor for TOD. This simple, practical indicator may help identify individuals at risk of early vascular damage in community settings.