Early Vascular Ageing - A Concept in Development

Abstract

Cardiovascular disease (CVD) is a prevalent condition in the elderly, often associated with metabolic disturbance and type 2 diabetes. For a number of years, research dedicated to understand atherosclerosis dominated, and for many good reasons, this pathophysiological process being proximal to the CVD events. In recent years, research has been devoted to an earlier stage of vascular pathology named arteriosclerosis (arterial stiffness) and the new concept of early vascular ageing (EVA), developed by a group of mostly European researchers. This overview describes recent developments in research dedicated to EVA and new emerging aspects found in studies of families at high cardiovascular risk. There are new aspects related to genetics, telomere biology and the role of gut microbiota. However, there is still no unifying definition available of EVA and no direct treatment, but rather only recommendations for conventional cardiovascular risk factor control. New interventions are being developed - not only new antihypertensive drugs, but also new drugs for vascular protection - the selective angiotensin-II (AT2) agonist Compound 21 (C21). Human studies are eagerly awaited. Even new functional food products could have the potential to positively influence cardiometabolic regulation, to be confirmed.

Keywords: Arterial ageing; C21; arterial stiffness; blood pressure; diet; drugs; glycaemia; hypertension; lipids; microbiota.

Figure 1:. Thomas Sydenham, ‘The English Hippocrates’, 1624–1689

Figure 2:. Level of Arterial Stiffness (c-f PWV) in Subjects with and without Diabetes

No diabetes: green bar; 83 %; undiagnosed diabetes: blue bar; 7 %; or diagnosed, prevalent diabetes: red bar; 10 % in the Malmö Diet Cancer Study, Malmö, Sweden (adapted from reference 18).