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Aging and vascular endothelial function in humans
Open accessAbstract
Advancing age is the major risk factor for the development of CVD (cardiovascular diseases). This is attributable, in part, to the development of vascular endothelial dysfunction, as indicated by reduced peripheral artery EDD (endothelium-dependent dilation) in response to chemical [typically ACh (acetylcholine)] or mechanical (intravascular shear) stimuli. Reduced bioavailability of the endothelium-synthesized dilating molecule NO (nitric oxide) as a result of oxidative stress is the key mechanism mediating reduced EDD with aging. Vascular oxidative stress increases with age as a consequence of greater production of reactive oxygen species (e.g. superoxide) without a compensatory increase in antioxidant defences. Sources of increased superoxide production include up-regulation of the oxidant enzyme NADPH oxidase, uncoupling of the normally NO-producing enzyme, eNOS (endothelial NO synthase) (due to reduced availability of the cofactor tetrahydrobiopterin) and increased mitochondrial synthesis during oxidative phosphorylation. Increased bioactivity of the potent endothelial-derived constricting factor ET-1 (endothelin-1), reduced endothelial production of/responsiveness to dilatory prostaglandins, the development of vascular inflammation, formation of AGEs (advanced glycation end-products), an increased rate of endothelial apoptosis and reduced expression of oestrogen receptor α (in postmenopausal females) also probably contribute to impaired EDD with aging. Several lifestyle and biological factors modulate vascular endothelial function with aging, including regular aerobic exercise, dietary factors (e.g. processed compared with non-processed foods), body weight/fatness, vitamin D status, menopause/oestrogen deficiency and a number of conventional and non-conventional risk factors for CVD. Given the number of older adults now and in the future, more information is needed on effective strategies for the prevention and treatment of vascular endothelial aging.
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“age-related declines in endothelial function and NO bioavailability can impair this process, resulting in reduced cerebral perfusion and cognitive decline [168,169].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [168]
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“which leads to peroxynitrite formation and endothelial damage [168,232].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [168]
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“Ageing is associated with reduced eNOS activity, increased arginase activity, and enhanced oxidative degradation of NO”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [168]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
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“structural vascular changes (e.g., intimal thickening and reduced capillary density) can restrict NO signalling in advanced disease [168,244].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [168]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
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“This compensatory pathway may be particularly important for older adults”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [168]
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“The key mechanism for reduced NO bioavailability with aging is oxidative stress (49, 164, 177).”
From Inorganic nitrite supplementation for healthy arterial aging (2014) · cites this paper as [164]
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“Reduced bioavailability of NO as a result of decreased production by endothelial NO synthase (eNOS), increased degradation, or both, also is the key mechanism mediating vascular endothelial dysfunction with aging (118, 164, 177).”
From Inorganic nitrite supplementation for healthy arterial aging (2014) · cites this paper as [164]
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Metadata
- Authors
- Seals, D. R., Jablonski, K. L., & Donato, A. J.
- Affiliations
- University of Colorado Boulder (US)
- Venue
- Clinical Science
- Publisher
- Portland Press Ltd.
- Published
- 2011-01-18
- Volume
- 120
- Issue
- 9
- Pages
- 357-375
- ISSN
- 0143-5221 (ISSN-L)
- 1470-8736
- PMC
- PMC3482987
- OpenAlex
- W1983986440
- Cited by
- 725
- References
- 191
- Citations by year
- 2026: 63 · 2025: 49 · 2024: 45 · 2023: 52 · 2022: 66 · 2021: 58 · 2020: 48 · 2019: 49 · 2018: 49 · 2017: 39 · 2016: 44 · 2015: 46 · 2014: 35 · 2013: 28 · 2012: 40
- FWCI
- 25.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (AG022241, K01AG029337, AG031141, AG-006537, R01AG031141, AG 029337, F31AG033994, R01AG022241, AG-000279, R37AG013038, R01AG013038, R01AG040297, R01AG006537, AG-013038, AG033994, T32AG000279)
- National Center for Research Resources (RR-00051, M01RR000051)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- vascular aging, endothelial dysfunction, endothelium-dependent dilation, nitric oxide bioavailability, oxidative stress, superoxide, NADPH oxidase, endothelial nitric oxide synthase, tetrahydrobiopterin, endothelin-1, advanced glycation end products, vascular inflammation, endothelial cell apoptosis, estrogen receptor alpha, menopause, aerobic exercise, dietary factors, vitamin D, cardiovascular risk
- MeSH terms
- Aging, Cardiovascular Diseases, Endothelium, Vascular, Humans, Inflammation, Nitric Oxide, Vasodilation, Exercise, Oxidative Stress
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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