Vascular Aging: Assessment and Intervention

Clin Interv Aging. 2023 Aug 17:18:1373-1395. doi: 10.2147/CIA.S423373. eCollection 2023.


Vascular aging represents a collection of structural and functional changes in a blood vessel with advancing age, including increased stiffness, vascular wall remodeling, loss of angiogenic ability, and endothelium-dependent vasodilation dysfunction. These age-related alterations may occur earlier in those who are at risk for or have cardiovascular diseases, therefore, are defined as early or premature vascular aging. Vascular aging contributes independently to cardio-cerebral vascular diseases (CCVDs). Thus, early diagnosis and interventions targeting vascular aging are of paramount importance in the delay or prevention of CCVDs. Here, we review the direct assessment of vascular aging by examining parameters that reflect changes in structure, function, or their compliance with age including arterial wall thickness and lumen diameter, endothelium-dependent vasodilation, arterial stiffness as well as indirect assessment through pathological studies of biomarkers including endothelial progenitor cell, lymphocytic telomeres, advanced glycation end-products, and C-reactive protein. Further, we evaluate how different types of interventions including lifestyle mediation, such as caloric restriction and salt intake, and treatments for hypertension, diabetes, and hyperlipidemia affect age-related vascular changes. As a single parameter or intervention targets only a certain vascular physiological change, it is recommended to use multiple parameters to evaluate and design intervention approaches accordingly to prevent systemic vascular aging in clinical practices or population-based studies.

Keywords: arterial stiffness; arterial wall thickness; endothelial function; therapeutic intervention; vascular aging.

Publication types

  • Review

MeSH terms

  • Aging*
  • C-Reactive Protein
  • Caloric Restriction
  • Cardiovascular Diseases* / prevention & control
  • Humans
  • Vasodilation


  • C-Reactive Protein

Grants and funding

This study was funded by the National Key Research and Development Program of the Ministry of Science and Technology, China (2020YFC2002900 to XLT), the Key Program of the National Natural Science Foundation of China (81630034 to XLT), and the Key Programs of the Jiangxi Province, China (20192ACB70002 and 20181BCD40001 to XLT).