Abstract: Compositions and methods are provided for the analysis and treatment of conditions relating to clonal hematopoiesis of indeterminate potential (CHIP). In some embodiments, treatment is provided to reduce the progression of CHIP, particularly to reduce the progression to hematologic malignancy and/or heart disease. In other embodiments, methods are provided for determining clonal expansion, for example as a molecular diagnostic test that enables determination of clonal growth rate from a single sample. The method for determining clonal expansion can be applied to identify factors that influence clonal expansion, including environmental, metabolic, microbiome, and genetic.