Trajectories of cardiovascular ageing-from molecular mechanisms to clinical implementation

Due to its peculiar structure and function, the cardiovascular system is particularly vulnerable to the detrimental effects of ageing. Current knowledge about the molecular mechanisms of ageing revealed the processes actively promoting ageing, e.g. progressive telomere shortening, and the mechanisms opposing it, e.g. endogenous production of antioxidant substances. This knowledge can be used to measure biological age at cellular and molecular levels and to interfere with it by pharmacological or non-pharmacological interventions. Biological ageing is determined by the simultaneous occurrence of independent hallmarks, which encompass a wide range of biological processes, from genomic changes to systemic inflammation and dysbiosis. This narrative review will summarize the role of ageing hallmarks in the cardiovascular system, how they can be measured, and what are the possible interventions to counteract their effects. Graphical Abstract Ageing-oriented strategies for prevention and treatment of cardio- and cerebrovascular diseases. Compared to conventional strategies for prevention and treatment of CVD and CBVD, which aim at controlling the progression of the risk factors to overt disease or the progression of the disease towards disability and death, ageing-oriented treatments aim at slowing down the progression of molecular and cellular ageing towards the overt risk factor.