Aging and Cardiovascular Health: CVIA State-of-the-Art Review

Abstract

Aging is an inevitable biological process marked by progressive functional decline and elevated risk of cardiovascular diseases (CVDs). This review systematically examines the clinical mechanisms linking aging to cardiovascular pathology, focusing on molecular, cellular, and physiological changes that contribute to cardiovascular aging, which in turn increases the incidence of heart failure, atherosclerosis, atrial fibrillation, and other diseases. Key mechanisms include metabolic dysregulation, mitochondrial dysfunction, chronic inflammation, cellular senescence, immune disorders, and epigenetic changes. Understanding these mechanisms is crucial for developing targeted interventions to delay cardiovascular aging and alleviate CVD burden in older people. Current therapeutic strategies, including lifestyle modifications, pharmacotherapy, gerotherapeutic interventions, and device-based management, are reviewed, along with future directions in precision medicine, development of novel therapeutic targets, multi-omics, and AI-powered strategies against cardiovascular aging.