Vascular aging: A central driver of multimorbidity

Area of Science:

• Cardiovascular Science
• Pharmacology
• Aging Research

Background:

• Vascular aging is a key factor in cardiovascular disease (CVD) risk and overall decline.
• Understanding molecular mechanisms of vascular aging is advancing, but clinical translation lags.
• Effective interventions for vascular aging remain a significant unmet need.

Purpose of the Study:

• To critically review the current landscape of vascular aging pharmacology.
• To dissect pathogenic mechanisms and identify clinical targets.
• To evaluate existing and novel therapeutic strategies and translational challenges.

Main Methods:

• Systematic evaluation of current and emerging therapeutic strategies for vascular aging.
• Analysis of core pathogenic mechanisms including epigenetic drift, inflammation, and senescence.
• Identification and discussion of translational bottlenecks in drug development.

Main Results:

• Key pathogenic mechanisms identified: epigenetic drift, inflammation, cellular senescence.
• Therapeutic strategies reviewed: repurposed metabolic drugs, mitochondrial antioxidants, senolytics, gene therapy.
• Major translational bottlenecks highlighted: animal model-human discordance, drug delivery, surrogate endpoints.

Conclusions:

• Future directions require precision medicine, novel clinical trial designs, and liquid biopsy biomarkers.
• Accelerating therapies for vascular aging necessitates addressing identified translational gaps.
• The ultimate goal is to enhance vascular health and resilience through targeted pharmacological interventions.