The number on your driver’s license indicates your chronological age, but the biological age of your blood vessels, known as your vascular age, offers a much more accurate measure of your long-term health prospects. Vascular age reflects the true condition of your circulatory system. For many people, arterial health is a stronger predictor of lifespan and freedom from major disease than the number of years they have lived.
Understanding the Concept of Vascular Age
Vascular age is a calculated estimate of a person’s cardiovascular health, based on the physical state and function of their arteries compared to the average for their chronological age group. A person with a vascular age significantly higher than their actual age has arteries that are aging prematurely. This concept centers on two primary physical changes that occur in the blood vessels: arterial stiffness and plaque accumulation.
Arterial stiffness, or arteriosclerosis, is the loss of elasticity in the major arteries, caused by structural changes like the breakdown of elastin and an increase in stiff collagen fibers. These changes make the arteries less able to expand and contract with each heartbeat. Atherosclerosis involves the buildup of fatty deposits, cholesterol, and cellular waste (plaque) inside the artery walls. Plaque buildup narrows the blood vessel channel, restricting blood flow and triggering inflammation.
While both arteriosclerosis and atherosclerosis contribute to vascular deterioration, the measurement of vascular age primarily focuses on the functional aspect of stiffness. Stiffer arteries can no longer effectively buffer the pulse wave generated by the heart, leading to increased pressure. This accelerated biological aging process is heavily influenced by factors like high blood pressure, elevated blood sugar, and chronic inflammation.
Methods for Assessing Vascular Health
Clinicians use several non-invasive techniques to assess the physical properties of the arteries and determine a patient’s vascular age. The most widely accepted method for measuring arterial stiffness is the Pulse Wave Velocity (PWV). This technique measures the speed at which the pressure wave from the heart travels between two points, most commonly the carotid artery in the neck and the femoral artery in the groin.
The carotid-femoral PWV is considered the gold standard because a faster pulse wave indicates stiffer arteries that are less compliant and older than expected. PWV is calculated by dividing the measured distance between the two points by the time it takes for the pulse wave to travel that distance. A typical measurement of 10 meters per second or higher is often used as a threshold indicating increased arterial stiffness and elevated cardiovascular risk.
Another common method is the Carotid Intima-Media Thickness (CIMT), which uses ultrasound to measure the thickness of the inner two layers of the carotid artery wall. Increased thickness suggests the presence of structural changes and early atherosclerotic burden. The Ankle-Brachial Index (ABI) compares the systolic blood pressure in the ankle to the pressure in the arm. A low ABI suggests restricted blood flow to the extremities, often due to peripheral artery disease, indicating systemic vascular aging.
Why Premature Aging of Arteries Matters
When vascular age outpaces chronological age, it indicates an increased risk of major cardiovascular events. Arterial stiffness creates a detrimental ripple effect throughout the circulatory system, forcing the heart to work harder against greater resistance. This increased workload can lead to left ventricular hypertrophy, where the heart muscle thickens, ultimately increasing the risk of heart failure.
The stiffening of the large arteries causes an increase in systolic blood pressure while often lowering diastolic pressure, resulting in a widened pulse pressure. This heightened pressure pulsatility is directly transmitted to the delicate microvasculature of vital organs, causing widespread damage over time. The small vessels in the brain and kidneys are particularly vulnerable to this pressure overload.
Damage to the brain’s microvessels due to premature arterial aging is strongly linked to an increased risk of stroke and is an important contributor to cognitive decline and vascular dementia. Similarly, in the kidneys, the delicate filtering units are damaged by the high-pressure waves, leading to chronic kidney disease and, eventually, kidney failure. By identifying a high vascular age, a patient and their physician can intervene early to mitigate these outcomes.
Lifestyle Changes to Lower Your Vascular Age
Fortunately, vascular age is not a fixed number, and targeted lifestyle modifications can often reverse or slow the progression of arterial aging. Adopting a heart-healthy diet, such as the Mediterranean or DASH eating plans, is highly effective, as these emphasize fruits, vegetables, whole grains, and healthy fats while limiting sodium and saturated fats. Reducing dietary sodium intake is particularly beneficial because it directly lowers blood pressure, which in turn reduces the mechanical strain on artery walls.
Regular physical activity is essential for improving arterial health and should include both aerobic and resistance training. Consistent aerobic exercise, such as brisk walking, running, or swimming, for about 150 minutes per week helps restore the elasticity of blood vessels by improving the function of the endothelium. Resistance training, like weight lifting, complements this by improving overall muscle strength and metabolic health, which indirectly benefits the vascular system.
Controlling established risk factors is essential, which means managing blood pressure, cholesterol levels, and blood sugar through a combination of lifestyle changes and, if necessary, medication. High blood pressure is a major accelerator of vascular aging, and maintaining optimal levels is a direct way to protect arterial health. Finally, managing chronic stress, which can elevate blood pressure and inflammation, through practices like mindfulness or yoga, supports the body’s ability to maintain a younger, more flexible vascular system.