PRIOR COVID-19 infection has been associated with accelerated vascular ageing, with new research indicating a lasting increase in large artery stiffness, particularly among women, even months after infection.
The long-term cardiovascular impact of COVID-19 has been unclear, although mounting evidence shows increased risks of heart and vascular problems after infection. The CARTESIAN study aimed to examine whether people who recovered from COVID-19 had signs of earlier vascular ageing, and to explore potential sex differences and underlying drivers. Vascular ageing is typically assessed through pulse wave velocity (PWV), a noninvasive measure of large artery stiffness, which is closely linked to cardiovascular risk.
In this multicentre, prospective cohort study, researchers enrolled 2,390 adults from 34 centres across 16 countries. Participants were divided into four groups: COVID-negative controls and three groups with varying severity of prior COVID-19 infection, including those not hospitalised, those hospitalised in general wards, and those treated in intensive care. Average participant age was 50 years and nearly half were women. After adjusting for factors such as age and cardiovascular risk, all groups with past COVID-19 infection had significantly higher PWV (increases of 0.37 to 0.41 metres per second, P ≤ .003) compared to controls. When results were analysed by sex, only women showed statistically significant increases in arterial stiffness. Persistent symptoms after infection were also linked to higher PWV among women, regardless of how severe their initial illness had been. Over a twelve-month period, PWV stabilised or improved in the COVID-positive participants, while it continued to progress among those who remained uninfected.
These findings suggest COVID-19 may have enduring effects on cardiovascular health and highlight the need for long-term monitoring post-recovery. Further research should target the mechanisms driving accelerated vascular ageing after COVID-19 and develop interventions to limit its long-term effects.
Reference
Rosa Maria Bruno RM et al.; the CARTESIAN Investigators. Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study. European Heart Journal. 2025;ehaf430.
