Vascular aging: implications, mechanisms, and interventions

Vascular aging is a critical process that plays a central role in the development of various age-related diseases, including cardiovascular disease, hypertension, and cognitive decline. This complex phenomenon is driven by endothelial dysfunction, oxidative stress, chronic inflammation, cellular senescence, endothelial stiffening, and vascular smooth muscle cell alterations, which collectively contribute to increased vascular stiffness and maladaptive vascular remodeling—hallmarks of aging blood vessels. This review explores these fundamental mechanisms and their contributions to the progressive decline in vascular health. Additionally, we discuss key biomarkers that reflect the extent of vascular aging and their potential as predictive tools for cardiovascular outcomes. These biomarkers provide essential insights into the progression of vascular aging and its broader systemic effects. The review also examines therapeutic strategies aimed at mitigating vascular aging, including both established and emerging interventions. These approaches, which range from lifestyle modifications to pharmacological treatments, hold promise for preserving vascular function and improving health outcomes in aging populations. By integrating the latest research findings, this review aims to deepen our understanding of vascular aging and its implications, offering insights that may guide the development of innovative strategies to enhance vascular health and promote longevity.