Early vascular aging (EVA): consequences and prevention

It has often been recognized that a discrepancy exists during the clinical consultation between the chronological age of a patient on the one hand with the signs and symptoms of biological age that can be recorded on the other hand. In cardiovascular medicine this is obvious when a heavy smoker presents with features of early biological aging, for example skin appearance and impaired lung function. This could also be extrapolated to vascular function as the target for numerous cardiovascular risk factors, thereby increasing the risk of early cardiovascular disease (CVD). Both new and old treatment modalities can play a role for the prevention of early vascular aging, first of all smoking cessation and improved lifestyle in general, but later on also the use of drugs such as statins or agents that block the renin – angiotensin system (RAS). New classes of drugs are currently being tested for CVD prevention, including glitazones and rimonabant, even if adverse effects (heart failure and depression) might restrict their usefulness. Results from ongoing intervention studies will eventually cast new light on possibilities to prevent the development of vascular aging.