Aging results in functional and structural changes in the cardiovascular system, translating into a progressive increase of mechanical vessel stiffness, due to a combination of changes in micro-RNA expression patterns, autophagy, arterial calcification, smooth muscle cell migration and proliferation. The two pivotal mechanisms of aging-related endothelial dysfunction are oxidative stress and inflammation, even in the absence of clinical disease. A comprehensive understanding of the aging process is emerging as a primary concern in literature, as vascular aging has recently become a target for prevention and treatment of cardiovascular disease. Change of life-style, diet, antioxidant regimens, anti-inflammatory treatments, senolytic drugs counteract the pro-aging pathways or target senescent cells modulating their detrimental effects. Such therapies aim to reduce the ineluctable burden of age and contrast aging-associated cardiovascular dysfunction. This narrative review intends to summarize the macrovascular and microvascular changes related with aging, as a better understanding of the pathways leading to arterial aging may contribute to design new mechanism-based therapeutic approaches to attenuate the features of vascular senescence and its clinical impact on the cardiovascular system.

中文翻译：

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随着年龄的增长，冠状动脉和心脏微血管的变化：对转化研究和临床实践的启示。

衰老会导致心血管系统的功能和结构发生变化，这归因于微RNA表达模式，自噬，动脉钙化，平滑肌细胞迁移和增殖的综合变化，从而导致机械血管僵硬度的逐渐增加。即使在没有临床疾病的情况下，与衰老相关的内皮功能障碍的两个关键机制是氧化应激和炎症。随着年龄的增长，血管衰老最近已成为预防和治疗心血管疾病的目标，对衰老过程的全面理解已成为文献中的主要关注点。生活方式，饮食，抗氧化方案，抗炎治疗，镇静药物的改变抵消了衰老途径或靶向衰老细胞，从而调节了它们的有害作用。这类疗法旨在减轻不可避免的年龄负担，并与衰老相关的心血管功能障碍进行对比。本篇综述旨在总结与衰老相关的大血管和微血管变化，因为更好地理解导致动脉衰老的途径可能有助于设计新的基于机制的治疗方法，以减轻血管衰老的特征及其对心血管的临床影响系统。