Arterial ageing

Abstract

The development of cardiovascular disease (CVD) starts with genetic factors increasing susceptibility, early life programming and later on the influence of risk factors and adverse lifestyle as well as negative social factors. For many years research focusing on the development of atherosclerosis has tried to find mechanisms and treatment targets for early manifestations of the pathophysiological changes leading to cardiovascular events. However, even prior to that, and later on in parallel, is the development of arterial stiffening, arteriosclerosis, as a result of changes in the structural content of the arterial wall with relatively less elastin and more collagen composites in the media of the large elastic arteries. This development can be quantified and measured as pulse wave velocity (PWV) along the aorta, in itself a predictor of future cardiovascular events. The new perspective is that arteriosclerosis resembles an ageing process of the elastic arteries. Thus, the concept of arterial ageing, or even early vascular ageing (EVA) that also embraces the microcirculation, has been developed for a better understanding of the very early morphological and haemodynamic changes leading to CVD. This approach has sparked new research into early mechanisms and finding new drugs to influence the ageing process and enhance vascular protection.