Early vascular aging and supernormal vascular aging : genetics, epigenetics, and the environment

• Published in: Textbook of Arterial Stiffness and Pulsatile Hemodynamics in Health and Disease p. 421
• Main Authors: Nilsson, Peter M., Laurent, Stéphane
• Format: Book Chapter
• Language: English
• Published: 01.01.2022
• Subjects: Aging; Aorta; Cardiac and Cardiovascular Systems; Clinical Medicine; Epigenetic; Genetic; Kardiologi; Klinisk medicin; Lifestyle; Medical and Health Sciences; Medicin och hälsovetenskap; Treatment; Vascular
• ISBN: 9780323913911; 9780323916486; 0323916481; 0323913911
• DOI: 10.1016/B978-0-323-91391-1.00027-3

Vascular aging (VA) is a reflection of biological aging in general and subject to many influences during the life course. It involves all aspects of the cardiovascular system but is most visible in the age-related increased arterial stiffness of large elastic arteries, such as the aorta. It is possible to measure this process by pulse wave velocity (PWV). Several studies have now documented that increased PWV is an independent risk marker for both cardiovascular and noncardiovascular events, as well as total mortality, in a range of population-based cohorts as well as in groups of patients, for example, with end-stage renal disease or inflammatory conditions. In some individuals, this process is taking a more rapid course, so called early vascular aging (EVA), with increased aortic PWV, even adjusted for other age, sex, and other hemodynamic variables as well as cardiovascular risk factors. However, in other more fortunate individuals, the vascular tree seems to be remarkably protected from such aging phenomena, even under the same risk factor burden—a variant of more healthy VA or even supernormal vascular aging (SUPERNOVA). This chapter focuses on the epidemiological, mechanistic, and treatment aspects of EVA and what can be learned about protective factors associated with SUPERNOVA. Ongoing studies try to test drugs that may favorably influence EVA and whether a treatment strategy based on addressing arterial stiffness could be more beneficial than conventional treatment based on blood pressure levels. Interesting aspects of genetics and epigenetics, as well as mechanotransduction and early life influences of VA will be further discussed.