Age and vascular aging: an unexplored frontier

Association between CAIDE risk score and episodic memory in middle-aged females: The impact of spontaneous menopause

There is growing evidence that postmenopause is associated with episodic memory decline in some females. Although midlife vascular risk factors are established predictors of brain health, it is unclear whether episodic memory decline at postmenopause is related to vascular risk, and whether such effects affect specific mnemonic functions (e.g. recollective processing vs. novelty detection). This study investigated whether vascular risk, measured by the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) score, predicts episodic memory in middle-aged females at pre- and post-menopause. Eighty-five cognitively unimpaired females (42 premenopausal, 43 postmenopausal) aged 39.5 to 65.1 years completed easy (low encoding load) and hard (high encoding load) versions of a face-location episodic memory task. Outcome measures were spatial source retrieval (correct source accuracy; CS) and detection of novel stimuli (correct rejections; CR). Linear-mixed models (LMMs) tested menopause group effects on CS and CR, while separate LMMs stratified by menopause status assessed whether CAIDE score predicted memory performance in each group. Results indicated that postmenopausal females performed worse than premenopausal females in both CS (β = 0.08, p < 0.001) and CR (β = 0.05, p = 0.011), with postmenopausal females more sensitive to task difficulty in CS. Higher CAIDE scores were associated with poorer CS accuracy in postmenopausal females only (β = -0.14, p = 0.009), with no effect on CR. These findings highlight the significance of vascular risk in episodic memory decline and emphasize the role of reproductive status in midlife cognition.

Impact of hypertension on cerebral small vessel disease: A post-mortem study of microvascular pathology from normal-appearing white matter into white matter hyperintensities

Cerebral small vessel disease (SVD) is diagnosed through imaging hallmarks like white matter hyperintensities (WMH). Novel hypotheses imply that endothelial dysfunction, blood-brain barrier (BBB) disruption and neurovascular inflammation contribute to conversion of normal-appearing white matter (NAWM) into WMH in hypertensive individuals. Aiming to unravel the association between chronic hypertension and the earliest WMH pathogenesis, we characterized microvascular pathology in periventricular NAWM into WMH in post-mortem brains of individuals with and without hypertension. Our second aim was to delineate the NAWM-WMH transition from NAWM towards the center of WMH using deep learning, refining WMH segmentation capturing increases in FLAIR signal. Finally, we aimed to demonstrate whether these processes may synergistically contribute to WMH pathogenesis by performing voxel-wise correlations between MRI and microvascular pathology. Larger endothelium disruption, BBB damage and neurovascular inflammation were observed in individuals with hypertension. We did not observe gradual BBB damage nor neurovascular inflammation along the NAWM-WMH transition. We found a strong correlation between BBB damage and neurovascular inflammation in all individuals in both periventricular NAWM and WMH. These novel findings suggest that endothelium disruption, BBB damage and neurovascular inflammation are major contributors to SVD progression, but being already present in NAWM in hypertension.

Association of Vascular Aging Phenotypes with Adverse Clinical Outcomes in the Chinese Population: A Multicentre Study

Purpose

This study aimed to investigate the clinical implications of vascular aging (VAg) phenotypes based on the difference between chronological age (CA) and vascular age (VA).

Patients and Methods

We defined VA as the predicted age in a multivariable linear regression model including structural and functional parameters of arteries and conventional risk factors, in a multicentric, cross-sectional cohort (n=15580). According to the 10th and 90th percentiles of Δ-age (CA minus VA), we then classified the status of VAg into 3 phenotypes: the early VAg (EVA), the Normal VAg and the supernormal VAg (SUPERNOVA). We used Cox survival analysis to investigate the association between VAg phenotypes and the risk for adverse clinical outcomes (including all-cause death and cardiovascular disease) in an independent, prospective cohort (n=5316).

Results

In the prospective cohort (11.07 years, 927 events), when compared to the Normal VAg phenotype, EVA had an increased risk (HR: 2.43; 95% CI: 1.80-3.27) and SUPERNOVA had a decrease risk (HR: 0.75; 95% CI: 0.64-0.90) of adverse clinical outcomes, in particular stroke events. EVA also showed a higher risk of myocardial infarction (HR: 3.21, 95% CI: 1.56-6.62) and all-cause death (HR: 1.79, 95% CI: 1.12-2.85). The associations were independent of the atherosclerotic cardiovascular disease risk score. Further, the C-statistics increased 0.010 (P < 0.001), 0.013 (P < 0.001) and 0.016 (P < 0.001) separately when adding baPWV, adding the combination of baPWV and CIMT, and adding the VAg phenotypes to a model of conventional risk factors in predicting cardiovascular events.

Conclusion

This is the first study to evaluate the clinical implications of VAg phenotypes using multicentric data and undergone external validation in China. Our results emphasized that the classification of VAg phenotypes may be a potential tool to identify individuals who were susceptible to or resilient to VAg.

Pathological and Inflammatory Consequences of Aging

Aging is a complex, progressive, and irreversible biological process that entails numerous structural and functional changes in the organism. These changes affect all bodily systems, reducing their ability to respond and adapt to the environment. Chronic inflammation is one of the key factors driving the development of age-related diseases, ultimately causing a substantial decline in the functional abilities of older individuals. This persistent inflammatory state (commonly known as "inflammaging") is characterized by elevated levels of pro-inflammatory cytokines, an increase in oxidative stress, and a perturbation of immune homeostasis. Several factors, including cellular senescence, contribute to this inflammatory milieu, thereby amplifying conditions such as cardiovascular disease, neurodegeneration, and metabolic disorders. Exploring the mechanisms of chronic inflammation in aging is essential for developing targeted interventions aimed at promoting healthy aging. This review explains the strong connection between aging and chronic inflammation, highlighting potential therapeutic approaches like pharmacological treatments, dietary strategies, and lifestyle changes.

Association Between Mediterranean Diet and Other Healthy Habits and Sociodemographic Variables with the Values of Vascular and Heart Age in Spanish Workers

Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through indicators such as vascular age (VA) and heart age (HA). Objective: This study aimed to investigate the relationship between sociodemographic factors, lifestyle behaviors, and their impact on VA and HA. Materials and Methods: A dual study design, encompassing both cross-sectional and longitudinal retrospective approaches, was conducted among a cohort of employees. The variables assessed included sociodemographic characteristics (age, sex, and socioeconomic status) and health-related habits (smoking, physical activity, adherence to the Mediterranean diet, and alcohol consumption). Results: The findings revealed that all analyzed variables were significantly associated with elevated VA and HA values. Among these, age demonstrated the strongest association, with odds ratios (OR) of 114.91 (95% CI: 100.45-131.43) for high HA and 34.48 (95% CI: 31.41-37.56) for high VA. Conclusions: The profile of individuals most at risk for elevated VA and HA encompasses males of advanced age, characterized by low socioeconomic status, a sedentary lifestyle, poor adherence to the Mediterranean diet, and regular alcohol consumption.

Gender Difference in Orthostatic Vascular Stiffness Increase in Young Subjects

Background/Objectives: Early detection of increased vascular stiffness in young populations may facilitate the development of more effective strategies for the primary prevention of arterial hypertension and other age-related cardiovascular diseases. To examine gender differences in orthostatic increases in vascular stiffness during the head-up tilt test (HUTT), standardized by hydrostatic column height. Materials and Methods: A total of 133 healthy adults aged 18-20 years (93 females and 40 males) were evaluated. Blood pressure and pulse wave velocity at the brachial-ankle artery site (baPWV) were measured using an ABI system 100 PWV multichannel sphygmomanometer. Orthostatic changes in arterial stiffness were assessed during a head-up tilt test (HUTT) using the Luanda protocol, which standardizes hydrostatic column height. The functional reserve coefficient (FRC) of orthostatic circulatory regulation was introduced as a measure of adaptive capacity: FRC = ΔbaPWV/baPWVb. This coefficient accounts for both structural (baPWVb) and functional (ΔbaPWV = baPWVt - baPWVb) components influencing cardiovascular system adaptation, which exhibit multidirectional changes with age. Results: Baseline baPWV (baPWVb) values in the horizontal position showed no significant differences between genders and were within normal age ranges. However, baPWV values in the upright HUTT position (baPWVt) were significantly higher in men (p = 0.0007). Dynamic biomarkers of vascular reserve, including ΔbaPWV and FRC, were also significantly elevated in men (p = 0.0009 and p = 0.0064, respectively). Conclusions: While baseline baPWVb values were comparable between genders, dynamic biomarkers of vascular reserve, such as ΔbaPWV and FRC, were significantly higher in men. Prospective studies are needed to establish optimal reference values for these dynamic biomarkers, enabling the assessment of individual trends in vascular aging and evaluating the effects of treatment, lifestyle modifications, and other preventive measures on vascular health.

Microvascular endothelial dysfunction in vascular senescence and disease

Cardiovascular disease (CVD) is the main cause of morbidity and mortality in the adult and the elderly, with increasing prevalence worldwide. A growing body of research has focused on the earliest stage of vascular decline-endothelial dysfunction (ED)-which at the microvascular level can anticipate in decades the diagnosis of CVD. This review aims to provide a prospect of the literature regarding the development of ED as an indissociable feature of the aging of the cardiovascular system, highlighting the role of inflammation in the process. Vascular aging consists of a lifelong continuum, which starts with cell respiration and its inherent production of reactive oxygen species. Molecular imbalance is followed by cellular epigenetic changes, which modulate immune cells, such as macrophage and lymphocyte subtypes. These mechanisms are influenced by lifestyle habits, which affect inflammation hotspots in organism, such as visceral fat and gut microbiota. The process can ultimately lead to an environment committed to the loss of the physiological functions of endothelial cells. In addition, we discuss lifestyle changes targeting the connection between age-related inflammation and vascular dysfunction. Addressing microvascular ED represents a critical endeavor in order to prevent or delay vascular aging and associated diseases.

Experimental Study on the Process and Performance of Pre-Dressing-Assisted Laser Joining of Vascular Tissues

Blood vessels are an important part of the human circulatory system. In clinical surgery, the common method for treating ruptured blood vessels is suturing, but this method can cause inflammatory reactions. With the popularization of lasers, they have been widely used in the medical field. However, due to the poor absorption of laser energy by tissues, the tensile strength of tissues after joining is low. To further improve the tensile strength after laser joining, this study analyzed the law of the effect of pre-dressing-assisted laser on the tensile strength and thermal denaturation of vascular tissues after joining with different components and concentrations by designing experiments. The experimental results showed that the tensile strength of the joined tissues could reach 50.978 KPa, and the degree of thermal denaturation was only 0.025, which is of great significance for the study of laser-joined vascular tissues.

Risk factors for dengue mortality: a 7-year retrospective cohort in Honduras

BACKGROUND

Dengue is the viral disease with the highest morbidity and mortality rates worldwide. The aim of this study was to describe the epidemiological trends of dengue cases and dengue death cases and identify the demographic, clinical and laboratory risk factors for dengue mortality in Honduras.

METHODS

A retrospective cohort study of suspected cases of dengue between 2016 and 2022 was conducted. Patients of the 18 departments of the country were included. Patients were classified as deceased and alive. In the univariate analysis, normality test was assessed. In bivariate analysis, the chi-square and Mann Whitney U tests were used as appropriate. Crude odds ratios (cOR) with their respective 95% confidence intervals (CIs), were estimated to determine the risk of death due to dengue. In multivariate analysis, a logistic regression model was built.

RESULTS

A total of 23,811 suspected cases of dengue were recorded, of which 14,927 tested positive, resulting in 242 deaths. The predominant sex among both deceased and surviving patients was female, 54.1% and 54.2%, respectively. Among the deceased, the largest age group was 5-9 years (32.6%), followed by 20-49 years (26.9%). Among surviving patients, the largest age groups were 20-49 years (28.9%) and 10-19 years (28.2%). Francisco Morazán reported the most dengue cases, while Cortés had the highest dengue deaths. Risk factors for dengue mortality included older age (> 60 years; adjusted OR 3.30, 95% CI 1.08-10.09), residence in the departments of Choluteca (aOR 19.40, 95% CI 4.75-79.30), Cortés (aOR 6.57, 95% CI 2.00-21.47), and Yoro (aOR 10.80, 95% CI 2.97-39.26), clinical manifestations of bleeding (aOR 1.81, 95% CI 1.09-3.00), clinical manifestations of plasma leakage (aOR 1.72, 95% CI 1.53-1.93), shock (aOR 10.70, 95% CI 7.90-14.50), lethargy (aOR 1.80, 95% CI 1.25-2.59), presence of comorbidities (aOR 1.89, 95% CI 1.08-3.29), and pregnancy (aOR 2.18, 95% CI 1.37-3.48).

CONCLUSION

Older age; residence in the departments of Choluteca, Cortés, and Yoro; clinical manifestations of bleeding, plasma leakage, shock, lethargy; comorbidities and pregnancy were identified as risk factors for dengue mortality. Early identification of risk factors can help recognize patients who require close and timely clinical monitoring, which could improve outcomes in terms of reducing dengue mortality.

Phonocardiography based pulse wave velocity system for non-occlusive assessment of arterial stiffness

Arterial stiffness is strongly associated with vascular aging and pathology and can be assessed in many ways. Existing devices for measuring central arterial stiffness, such as carotid-femoral pulse wave velocity (PWV), are limited by high costs and the need for specialized expertise, limiting widespread clinical adoption. This study introduces a semi- and non-occlusive PWV measurement system using phonocardiography (PCG) and plethysmography (PPG) and a single femoral pressure cuff, aiming to address these limitations. We conducted a study comparing a semi-occlusive (carotid-femoral PWV) and a non-occlusive (carotid-toe PWV) PCG-based PWV measurements across a cohort of 63 volunteers, as compared to literature reference PWV values. Results demonstrated strong correlations between our PCG-based PWV measures (PWVcarotid-femoral: 8.42 ± 3.99 m/s vs. PWVcarotid-toe: 10.62 ± 3.86 m/s) with age as a significant predictor (PWVcarotid-femoral: r 2 = 0.45; PWVcarotid-toe: r 2 = 0.28, p < 0.05). Ultrasound measured distensibility assessments confirmed the reliability of our PCG approach in reflecting central arterial stiffness dynamics, particularly at the aortic level. Test-retest reliability analyses yielded high intraclass correlation coefficients (0.75 ≤ ICC ≤ 90), indicating robust repeatability of our method. This study highlights the feasibility and accuracy of our low-cost, semi and non-occlusive PWV measurement systems to enhance accessibility in arterial stiffness assessments, potentially easing cardiovascular risk stratification.

Associations between heavy metal exposure and vascular age: a large cross-sectional study

BACKGROUND

Heavy metal exposure is an emerging environmental risk factor linked to cardiovascular disease (CVD) through its effects on vascular ageing. However, the relationship between heavy metal exposure and vascular age have not been fully elucidated.

METHODS

This cross-sectional study analyzed data from 3,772 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2016. We measured urinary concentrations of nine heavy metals and assessed their associations with vascular age, estimated pulse wave velocity (ePWV) and heart vascular age (HVA). Additionally, sex-stratified analyses, Weighted Quantile Sum (WQS) regression and Bayesian Kernel Machine Regression were conducted to explore the effects of individual and mixed metal exposures.

RESULTS

Exposure to metals such as cadmium (Cd) cesium (Cs), cobalt (Co), and lead (Pb) was significantly associated with increased vascular age, with odds ratios (OR) ranging from 1.05 to 3.48 in full adjusted models. Sex-stratified analyses indicated that individual metal including cobalt (Co) and cadmium (Cd) exposures had a more substantial impact on males. WQS analysis consistently showed combined heavy metals exposure had stronger associations with increased vascular age in men (OR for HVA = 3.89, 95% CI 2.91-5.28).

CONCLUSIONS

This study highlights a significant association between heavy metal exposure and increased vascular age. Stratified analyses illustrated men might be more susceptible to the combined effects of multiple heavy metal exposure. The findings underscore the importance of considering sex-specific responses and interventions measures in cardiovascular risk assessments and managements. Further research is needed to validate these findings and to develop more precise public health strategies targeting environmental risks.

Association of serum resolvin D1 with the risk of major adverse cardiovascular events in hemodialysis patients

PURPOSE

Resolvin D1 (RvD1) inhibits inflammation, reduces oxidative stress, and forecasts the risk of cardiovascular events, but relevant evidence in hemodialysis patients is lacking. This study intended to investigate the predictive value of RvD1 for major adverse cardiovascular events (MACE) risk in hemodialysis patients.

METHODS

Totally, 252 patients who underwent hemodialysis were included. Serum RvD1 was measured by enzyme-linked immunosorbent assay. Patients were followed up with a median of 12.1 months. MACE was recorded during the follow-up period.

RESULTS

RvD1 was inversely correlated with diabetes history (P = 0.002), cardiac troponin T (TnT) (P = 0.029), and high sensitivity C-reactive protein (hsCRP) (P < 0.001) in hemodialysis patients. 25 hemodialysis patients experienced MACE. RvD1 was reduced in hemodialysis patients with MACE versus those without MACE (P = 0.004). RvD1 exhibited a certain value in forecasting MACE risk, with an area under curve (AUC) of 0.675 [95% confidence interval CI: 0.565-0.786]. Increased RvD1 cut by median (P = 0.043) and cut by quartile (P = 0.042) were related to decreased accumulating MACE in hemodialysis patients. Moreover, RvD1 independently predicted declined MACE risk [odds ratio (OR) = 0.644, P = 0.045], but age (OR = 1.048, P = 0.039) and TnT (OR = 1.006, P = 0.005) independently predicted ascended MACE risk in hemodialysis patients. The combination of these independent factors displayed a good value for estimating MACE risk in hemodialysis patients with an AUC of 0.744 (95% CI: 0.640-0.849).

CONCLUSION

Serum RvD1 is inversely correlated with diabetes history, TnT, and hsCRP in hemodialysis patients. More importantly, it could serve as a potential marker to predict MACE risk in these patients.

Association between depression and vascular aging: a comprehensive analysis of predictive value and mortality risks

BACKGROUND

Depression is a significant global health concern, projected to become the leading disease burden. Vascular burden has been implicated in the pathogenesis of depression. Conversely, whether depression independently influences the process of vascular aging is unknown. This study aims to investigate the mutual relationship between vascular age and depression.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey (NHANES), the study included 27,764 participants after exclusions. Depression was assessed using the Patient Health Questionnaire (PHQ-9). Vascular aging was assessed by estimated pulse wave velocity (ePWV) and the heart age/vascular age (HVA) based on Framingham Risk Score (FRS). The study employed weighted logistic regression and Cox proportional hazards models to analyze the association between vascular age and depression as well as its mortality risk. Mendelian randomization was utilized to explore the causal associations.

RESULTS

Individuals with depression exhibited a higher risk of an advanced vascular age over their chronological age. Mendelian randomization analysis indicated a causal relationship between depression and arterial stiffness. A significant association was found between vascular age and depression incidence with odds ratios ranging from 1.10 to 1.38. As vascular age increased, the risk of mortality in individuals with depression increased by 22 % and 46 %, respectively.

LIMITATIONS

The study design limits the exploration of the dynamic relationship between changes in vascular age and depression due to the single timepoint measurement.

CONCLUSION

This study highlights the bidirectional relationship between depression and vascular age. Vascular age is a significant biomarker for the risk and prognosis of depression, while depression may contribute to vascular aging, which underscores the importance of integrated strategies for managing both vascular health and depression.

Vascular Extracellular Matrix in Atherosclerosis

The extracellular matrix (ECM) plays a central role in the structural integrity and functionality of the cardiovascular system. Moreover, the ECM is involved in atherosclerotic plaque formation and stability. In fact, ECM remodeling affects plaque stability, cellular migration, and inflammatory responses. Collagens, fibronectin, laminin, elastin, and proteoglycans are crucial proteins during atherosclerosis development. This dynamic remodeling is driven by proteolytic enzymes such as matrix metalloproteinases (MMPs), cathepsins, and serine proteases. Exploring and investigating ECM dynamics is an important step to designing innovative therapeutic strategies targeting ECM remodeling mechanisms, thus offering significant advantages in the management of cardiovascular diseases. This review illustrates the structure and role of vascular ECM, presenting a new perspective on ECM remodeling and its potential as a therapeutic target in atherosclerosis treatments.

Dual-edged role of SIRT1 in energy metabolism and cardiovascular disease

Regulation of energy metabolism is pivotal in the development of cardiovascular diseases. Dysregulation in mitochondrial fatty acid oxidation has been linked to cardiac lipid accumulation and diabetic cardiomyopathy. Sirtuin 1 (SIRT1) is a deacetylase that regulates the acetylation of various proteins involved in mitochondrial energy metabolism. SIRT1 mediates energy metabolism by directly and indirectly affecting multiple aspects of mitochondrial processes, such as mitochondrial biogenesis. SIRT1 interacts with essential mitochondrial energy regulators such as peroxisome proliferator-activated receptor-α (PPARα), PPARγ coactivator-1α, estrogen-related receptor-α, and their downstream targets. Apart from that, SIRT1 regulates additional proteins, including forkhead box protein O1 and AMP-activated protein kinase in cardiac disease. Interestingly, studies have also shown that the expression of SIRT1 plays a dual-edged role in energy metabolism. Depending on the physiological state, SIRT1 expression can be detrimental or protective. This review focuses on the molecular pathways through which SIRT1 regulates energy metabolism in cardiovascular diseases. We will review SIRT1 and discuss its role in cardiac energy metabolism and its benefits and detrimental effects in heart disease.

The Association between Food Groups, Nutraceuticals, and Food Supplements Consumption on Vascular Health Outcomes: A Literature Review

Vascular aging, marked by alterations in the structure and function of blood vessels, including heightened arterial stiffness and impaired endothelial function, is linked to a higher likelihood of developing cardiovascular and age-associated pathological conditions. Oxidative stress and inflammation are key stimulation factors in vascular aging. Engaging in healthy dietary habits could enhance the functioning of blood vessels. The aim of this study was to conduct a literature review of the evidence regarding the relationship between food regimens, nutraceuticals, and dietary supplements and vascular health. A search of electronic databases, including PubMed, Scopus, and Web of Science Core Collection, was performed. Experimental and observational studies evaluating the association between food groups, nutraceuticals, supplements, and endothelial function and/or arterial stiffness were deemed eligible for this narrative review. Based on the current body of the included studies, food groups, nutraceuticals, and dietary supplements may not demonstrate superiority over placebos in enhancing markers of vascular health. To obtain more reliable evidence on the effectiveness of interventions in vascular health, additional RCTs with larger sample sizes, extended follow-up periods, and multi-center participation are necessary. Enhancing the credibility of these RCTs requires better control of dietary variables and more precise measurement of vascular health markers.

Heterogeneity of aging and mortality risk among individuals with hypertension: Insights from phenotypic age and phenotypic age acceleration

OBJECTIVES

Hypertension, a key contributor to mortality, is impacted by biological aging. We investigated the relationship between novel biological aging metrics - Phenotypic Age (PA) and Phenotypic Age Acceleration (PAA) - and mortality in individuals with hypertension, exploring the mediating effects of arterial stiffness (estimated Pulse Wave Velocity, ePWV), and Heart/Vascular Age (HVA).

METHODS

Using data from 62,160 National Health and Nutrition Examination Survey (NHANES) participants (1999-2010), we selected 4,228 individuals with hypertension and computed PA, PAA, HVA, and ePWV. Weighted, multivariable Cox regression analysis yielded Hazard Ratios (HRs) relating PA, PAA to mortality, and mediation roles of ePWV, PAA, HVA were evaluated. Mendelian randomization (MR) analysis was employed to investigate causality between genetically inferred PAA and hypertension.

RESULTS

Over a 12-year median follow-up, PA and PAA were tied to increased mortality risks in individuals with hypertension. All-cause mortality hazard ratios per 10-year PA and PAA increments were 1.96 (95% CI, 1.81-2.11) and 1.67 (95% CI, 1.52-1.85), respectively. Cardiovascular mortality HRs were 2.32 (95% CI, 1.97-2.73) and 1.93 (95% CI, 1.65-2.26) for PA and PAA, respectively. ePWV, PAA, and HVA mediated 42%, 30.3%, and 6.9% of PA's impact on mortality, respectively. Mendelian randomization highlighted a causal link between PAA genetics and hypertension (OR = 1.002; 95% CI, 1.000-1.003).

CONCLUSION

PA and PAA, enhancing cardiovascular risk scores by integrating diverse biomarkers, offer vital insights for aging and mortality evaluation in individuals with hypertension, suggesting avenues for intensified aging mitigation and cardiovascular issue prevention. Validations in varied populations and explorations of underlying mechanisms are warranted.