Today’s research results provide data to indicate the degree to which vascular stiffening and hypertension across today’s population are the consequences of avoidable lifestyle choices and environmental factors rather than consequences of unavoidable processes of damage. The study suggests that cardiovascular aging can be influenced considerably until a comparatively late age, and in this it may be one of the most malleable of the many distinct aspects of aging. All of aging is some mix of primary and secondary contributions, varying widely between organs and circumstances. One can think of primary aging as the list of cell and tissue damage described in the SENS program, causes of aging that occur as a consequence of the normal, healthy operation of metabolism. Secondary aging, on the other hand, is some mix of being overweight, living a sedentary lifestyle, exposure to a toxic environment that spurs inflammation, exposure to pathogens that wear down the immune system, and so forth. Choices and environment, in other words – things that are optional or at least to some degree avoidable, and which act to accelerate the pace at which fundamental damage accrues.
Raised blood pressure, hypertension, is a good marker for cardiovascular mortality, and lowered blood pressure obtained through pharmacology and lifestyle changes have resulted in a considerable reduction in that rate of death over the past few decades. There is good evidence for hypertension to be largely caused by the stiffening of blood vessels, and the changes that loss of elasticity produces in the systems of feedback that guide blood flow and heart activity. Stiffening of blood vessels in turn is caused by a range of mechanisms, including calcification, the inflammatory activity of senescent cells, and the presence of cross-links in the extracellular matrix of blood vessel walls. Some of these contributing factors are more easily adjusted than others – levels of inflammation, for example. So while on the one hand it is encouraging to see that presently available courses of action can make some difference, on the other hand it all still ends in the same place, at least until such time as rejuvenation therapies after the SENS model of damage repair are developed. The manifestations of aging are produced by damage, and until that damage can be effectively repaired, there is only so far you can go with an optimal approach to secondary aging.
Potentially dangerous artery problems considered common as people age may actually be avoided or delayed well into the senior years, according to new research. The risk for high blood pressure and increased blood vessel stiffness, which both increase the risk of heart disease, may be reduced with a healthy lifestyle. There’s a catch, though: It takes a lot of work. “What we are showing is that, even in a population acculturated to a Western lifestyle, it is possible to maintain a healthy vasculature over age 70. But it is extremely challenging.”
The researchers defined healthy vascular aging as absence of high blood pressure and having vascular stiffness of the arteries of a person 30 years or younger. In a study of nearly 3,200 people ages 50 and older from the Framingham Heart Study, researchers found 566 individuals, or nearly 18 percent, met the requirements for healthy vascular aging. Most were in the youngest group, ages 50 to 59, where about 30 percent had the measures of healthy vascular aging. Among those 70 and older, only 1 percent had the soft arteries of a 30-something. “People with healthy vascular aging were at a 55 percent lower risk of developing cardiovascular disease. Those results are mainly a result of the softness of their arteries.” Most importantly, having a low body mass index and being free of diabetes seemed to be associated with healthier arteries into old age. Other factors, including use of lipid-lowering drugs, also made a difference.
Hypertension and increased vascular stiffness are viewed as inevitable parts of aging. To elucidate whether the age-related decrease in vascular function is avoidable, we assessed the prevalence, correlates, and prognosis of healthy vascular aging (HVA) in 3,196 Framingham Study participants aged ≥50 years. We defined HVA as absence of hypertension and pulse wave velocity of less than 7.6 m/s. Overall, 566 (17.7%) individuals had HVA, with prevalence decreasing from 30.3% in people aged 50 to 59 to 1% in those aged ≥70 years.
In regression models adjusted for physical activity, caloric intake, and traditional cardiovascular disease (CVD) risk factors, we observed that lower age, female sex, lower body mass index, use of lipid-lowering drugs, and absence of diabetes mellitus were cross-sectionally associated with HVA. Although HVA is achievable in individuals acculturated to a Western lifestyle, maintaining normal vascular function beyond 70 years of age is challenging. Although our data are observational, our findings support prevention strategies targeting modifiable factors and behaviors and obesity, in particular, to prevent or delay vascular aging and the associated risk of CVD.