Early vascular aging syndrome: background and proposed definitions

Author(s): Peter Nilsson

Vascular aging is a process linked to arterial stiffness and remodeling, as well as increased pulse wave velocity (PWV). Other aspects involve structural changes in the vascular tree that might have been influenced by detrimental factors in early life, such as impaired fetal growth or preterm birth, especially in combination with a rapid postnatal catch-up growth. Based on data from several European populations, normal reference values for PWV in defined age groups were published in 2010. Thus, outliers from the normal range can be defined and thus labeled with early vascular aging (EVA), as arterial stiffness is a major marker of EVA. Another approach to define EVA is to describe the component of PWV that cannot be explained by conventional cardiovascular risk factors alone. New therapies are emerging for treatment of EVA, beyond traditional risk factor control. One option could be the breaking up of glycation linkages in arterial tissue, or the use of new antidiabetes drugs with vascular actions, such as incretin analogues or DPP-4 inhibitors, for cardiovascular protection.