DNA Methylation Signatures of Cardiovascular Health Provide Insights Into Diseases

M Madeleine Carbonneau (Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (M.C., T.H., R.J., D.L.).) Y Yi Li Y Yishu Qu (Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Q., Y.Z., J.W., H.N., L.H., D.L.-J.).) Y Yinan Zheng A Alexis C. Wood M Mengyao Wang (Key Laboratory of Applied Surface and Colloid Chemistry (MOE), School of Chemistry and Chemical Engineering) C Chunyu Liu (Department of Psychiatry, State University of New York Upstate Medical University) T Tianxiao Huan R Roby Joehanes (Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.) X Xiuqing Guo J Jie Yao K Kent D. Taylor (The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.) R Russell P. Tracy (Laboratory for Clinical Biochemistry Research, Larner College of Medicine, University of Vermont, Burlington, VT, USA.) P Peter Durda (Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA.) Y Yongmei Liu (Division of Cardiology, Department of Medicine, School of Medicine, Duke University, Durham, NC, USA.) W W. Craig Johnson (Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, USA.) W Wendy S. Post T Tom Blackwell (Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI (T.B.).) J Jerome I. Rotter S Stephen S. Rich (Department of Genome Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA.) S Susan Redline M Myriam Fornage J Jun Wang H Hongyan Ning (NORTHWESTERN UNIVERSITY, Chicago, Illinois, United States) L Lifang Hou D Donald Lloyd-Jones (Framingham Center for Population and Prevention Science, Framingham, MA) K Kendra Ferrier Y Yuan-I. Min (Department of Medicine, University of Mississippi Medical Center, Jackson, MS (Y.-I.M., A.P.C.).) A April P. Carson L Laura M. Raffield (Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.) A Alexander Teumer H Hans J. Grabe H Henry Völzke M Matthias Nauck M Marcus Dörr A Arce Domingo-Relloso A Amanda Fretts (University of Washington School of Public Health, Seattle, Washington, United States) M Maria Tellez-Plaza (Department of Chronic Disease Epidemiology, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain (M.T.-P.).) S Shelley A. Cole (Population Health Program, Texas Biomedical Research Institute, San Antonio, TX (S.A.C.).) A Ana Navas-Acien (Columbia University, New York, New York, United States) M Meng Wang J Joanne M. Murabito N Nancy L. Heard-Costa B Brenton Prescott (Boston University, Boston, Massachusetts, United States) V Vanessa Xanthakis D Dariush Mozaffarian (Food Is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston) D Daniel Levy (Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.) J Jiantao Ma

Abstract

BACKGROUND: The association of overall cardiovascular health (CVH) with changes in DNA methylation (DNAm) has not been well characterized. METHODS: We calculated the American Heart Association’s Life’s Essential 8 score to reflect CVH in 5 cohorts with diverse backgrounds (mean age 54 years, 55% women, and enrollment year ranging from 1989 to 2012). Epigenome-wide association studies (EWAS) for Life’s Essential 8 score were conducted, followed by bioinformatic analyses. DNAm loci significantly associated with Life’s Essential 8 score were used to calculate a CVH DNAm score. We examined the association of the CVH DNAm score with incident cardiovascular disease (CVD), cardiovascular disease–specific mortality, and all-cause mortality. RESULTS: We identified 609 cytosine-phosphate-guanines (CpGs) associated with Life’s Essential 8 score at false discovery rate<0.05 in the discovery analysis and at Bonferroni-corrected P <0.05 in the multicohort replication stage. Most had low to moderate heterogeneity (414 CpGs [68.0%] with heterogeneity <0.2) in replication analysis. Pathway enrichment analyses and a phenome-wide association study search associated these CpGs with inflammatory or autoimmune phenotypes. We observed enrichment for phenotypes in the Epigenome-Wide Association Study Catalog, with 29-fold enrichment for stroke ( P =2.4e−15) and 21-fold for ischemic heart disease ( P =7.4e−38). Two-sample Mendelian randomization (MR) analysis showed significant association between 141 CpGs and ten phenotypes (261 CpG-phenotype pairs) at false discovery rate<0.05. For example, hypomethylation at cg20544516 ( MIR33B [microRNA 33b] and SREBF1 [sterol regulatory element–binding transcription factor 1]) is associated with a lower risk of stroke ( P =8.1e−6). In multivariable prospective analyses, the CVH DNAm score was consistently associated with clinical outcomes across participating cohorts. Per SD increase in the CVH DNAm score, the decrease in risk of incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality ranged from 19% to 32%, 28% to 40%, and 27% to 45%, respectively. CONCLUSIONS: We identified new DNAm signatures for CVH across diverse cohorts. Our analyses indicate that multiple biological pathways may be relevant to the observed association between CVH and clinical outcomes.

Article Details

Journal Circulation
Volume / Issue Vol. 152, Issue 7
Published August 19, 2025
Pages 436-449
ISSN 0009-7322
Publisher Lippincott Williams & Wilkins

Journal Info

Circulation

Lippincott Williams & Wilkins

ISSN: 0009-7322 Health Sciences

Authors (48)

M

Madeleine Carbonneau

Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (M.C., T.H., R.J., D.L.).

Y

Yi Li

Y

Yishu Qu

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Q., Y.Z., J.W., H.N., L.H., D.L.-J.).

Y

Yinan Zheng

A

Alexis C. Wood

M

Mengyao Wang

Key Laboratory of Applied Surface and Colloid Chemistry (MOE), School of Chemistry and Chemical Engineering

C

Chunyu Liu

Department of Psychiatry, State University of New York Upstate Medical University

T

Tianxiao Huan

R

Roby Joehanes

Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.

X

Xiuqing Guo

J

Jie Yao

K

Kent D. Taylor

The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.

R

Russell P. Tracy

Laboratory for Clinical Biochemistry Research, Larner College of Medicine, University of Vermont, Burlington, VT, USA.

P

Peter Durda

Department of Pathology and Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA.

Y

Yongmei Liu

Division of Cardiology, Department of Medicine, School of Medicine, Duke University, Durham, NC, USA.

W

W. Craig Johnson

Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, USA.

W

Wendy S. Post

T

Tom Blackwell

Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI (T.B.).

J

Jerome I. Rotter

S

Stephen S. Rich

Department of Genome Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA.

S

Susan Redline

M

Myriam Fornage

J

Jun Wang

H

Hongyan Ning

NORTHWESTERN UNIVERSITY, Chicago, Illinois, United States

L

Lifang Hou

D

Donald Lloyd-Jones

Framingham Center for Population and Prevention Science, Framingham, MA

K

Kendra Ferrier

Y

Yuan-I. Min

Department of Medicine, University of Mississippi Medical Center, Jackson, MS (Y.-I.M., A.P.C.).

A

April P. Carson

L

Laura M. Raffield

Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

A

Alexander Teumer

H

Hans J. Grabe

H

Henry Völzke

M

Matthias Nauck

M

Marcus Dörr

A

Arce Domingo-Relloso

A

Amanda Fretts

University of Washington School of Public Health, Seattle, Washington, United States

M

Maria Tellez-Plaza

Department of Chronic Disease Epidemiology, National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain (M.T.-P.).

S

Shelley A. Cole

Population Health Program, Texas Biomedical Research Institute, San Antonio, TX (S.A.C.).

A

Ana Navas-Acien

Columbia University, New York, New York, United States

M

Meng Wang

J

Joanne M. Murabito

N

Nancy L. Heard-Costa

B

Brenton Prescott

Boston University, Boston, Massachusetts, United States

V

Vanessa Xanthakis

D

Dariush Mozaffarian

Food Is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston

D

Daniel Levy

Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.

J

Jiantao Ma