What does a vascular age measurement (stiffness of your blood vessels) tell you about your health?
A high vascular age on the measurement is a serious signal: your risk of cardiovascular disease, dementia, and premature death is considerably elevated. Discuss it with your doctor, as there are lifestyle and medication options to slow arterial stiffness.
Arterial stiffness is clearly associated with the risk of serious conditions. People with the stiffest blood vessels are more than twice as likely to have a cardiovascular event as people with the most flexible vessels. Each step up in arterial stiffness increases the adjusted risk by approximately 14%. This matters beyond the heart: in a large, long-running population study of 7,283 people with an average follow-up of 15 years, greater arterial stiffness was also linked to a higher likelihood of high blood pressure (plus 32%), diabetes (plus 32%), kidney disease (plus 19%), dementia (plus 27%), and premature death (plus 29%).
The mechanism is biologically well understood. Stiff large blood vessels absorb the pressure waves of each heartbeat less effectively. Those waves then arrive with greater force in the small blood vessels of the brain, kidneys, and heart, causing damage to those organs. In addition, high blood pressure further increases arterial stiffness, and arterial stiffness in turn makes blood pressure harder to control, creating a self-reinforcing cycle.
Arterial stiffness begins to increase as early as childhood: on average it rises by 0.2 to 0.7 m/s every five years of life. Age is the biggest driver, but high blood pressure, diabetes, smoking, and an unhealthy lifestyle demonstrably accelerate the process. A blood pressure that is 20 mmHg higher leads, independently of age, to an additional increase of approximately 1.14 m/s per decade.
The measurement can also be expressed as a biological vascular age. A 50-year-old may, in vascular terms, be closer to 60, or equally to 40. This makes the test useful for risk estimation. Whether treatment decisions can be based on it in everyday clinical practice, however, has not yet been fully established. Medications such as blood pressure-lowering drugs can reduce arterial stiffness, but it has not yet been shown that this improvement actually leads to fewer cardiovascular events. In people with severe kidney failure, the measurement probably adds little on top of existing risk scores.
The evidence for the association between arterial stiffness and cardiovascular disease rests on a summary of 17 studies and on a large, long-running population study involving 7,283 participants over 15 years. The association with dementia, diabetes, and kidney disease comes from that latter study and is promising but has not yet been proven to be causal. As for whether reducing arterial stiffness with medication actually prevents cardiovascular disease, well-designed randomised trials are lacking.