Defining early vascular aging in youth: an expert consensus document from the youth vascular consortium

Abstract

The concept of early vascular aging (EVA) was introduced to identify adults at risk of developing premature cardiovascular disease. EVA, or the dissociation between chronologic and biologic age of large arteries, is an evolving concept. In this review, we propose that EVA in youth characterizes the early life biological and environmental risk factors that precede overt EVA. During early infancy, childhood and/or adolescence, structural and/or functional characteristics of the macrovascular and/or microvascular system may deviate from that expected for the chronological age of the individual. Assessing vascular aging from a young age may help detect and prevent the early onset of cardiovascular disease. This consensus document from the Youth Vascular Consortium outlines the principles of EVA in youth (birth to 24 years), examines factors influencing vascular growth, and identifies current knowledge gaps. It also provides an expert consensus on defining EVA in youth. Supplementary Tables 1-3, http://links.lww.com/HJH/C733 , http://links.lww.com/HJH/C734 , http://links.lww.com/HJH/C735 supply key references for risk factors associated with EVA at different points in development; 1. Neonates to childhood; 2. Adolescence; 3. Young adults. Supplementary Table 4, http://links.lww.com/HJH/C736 displays reference ranges of EVA in adults.

Keywords: adolescence; arterial aging; arterial stiffness; arteriosclerosis; atherosclerosis; biological maturation; childhood; early vascular aging; pulse wave velocity.