Arterial ageing is a process that can be quantified, at least to some degree, by measurement of pulse wave velocity along the aorta, the largest elastic artery, as a marker of arterial stiffness. In recent years the new concept of early vascular ageing (EVA) has been developed by a group of mostly European researchers and some reviews have been published. Based on a lecture given at the European Association for the Study of Diabetes (EASD) Meeting in Vienna 2014, this review was written to describe recent developments in research dedicated to EVA and new emerging aspects found in studies of families at high cardiovascular (CV) risk. This brings new perspectives related to genetics, telomere biology, and the role of gut microbiota. Even if EVA has been described in general terms there is still no unifying definition available and no direct treatment, only recommendations for conventional CV risk factor control. However, a new intervention study (SPARTE) is ongoing in France with a randomised design to treat arterial stiffness in patients with hypertension versus conventional treatment strategies. Results are expected in a few years and will be of importance in defining the role of arterial stiffness, a core feature of EVA, as a target for treatment.
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