With advancing age, changes in the arterial wall con tribute to what has been called vascular aging, and insome prematurely affected subjects even early vascular aging(EVA).1–5 Several years ago,1 we listed various componentsof EVA, including arteriosclerosis, atherosclerosis, and excess vasoconstriction, with their clinical expression: arterialstiffening and increased central pulse pressure, carotid intimamedia thickening and endothelial dysfunction, and increasedtotal peripheral resistance, respectively. In this review, wefocus on arteriosclerosis, ie, arterial stiffening, for several reasons: this is the most characteristic clinical feature of the agingprocess of the arterial system,6 its measurement has been wellstandardized and referenced,7,8 and an increasing number ofepidemiological studies have analyzed its independent determinants.9–11 Increased pulse wave velocity (PWV) is the established hallmark of arterial stiffening and is suggested to be oneof the best biomarkers available to calculate the prospectivecardiovascular risk and mortality risk of an individual.9,10,12,13EVA can be diagnosed in subjects who present an abnormallyhigh arterial stiffness for their age and sex.
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