Phenotypes of Vascular Aging

There are two sides to the discussion of phenotypes in vascular aging. One is to acknowledge that different biological phenotypes have a clear interaction with vascular aging and are responsible for modulating its progression or for mediating the effect of different risk factors in its progression. The other is to comprehend that chronobiologic asynchrony determines phenotypes of vascular aging that carry different risks of vascular disease and may potentially be of use in clinical practice in primary or secondary prevention strategies and precision medicine decisions. It should be clear that the authors are not pushing the agenda that pulse wave velocity (PWV) should be used as a treatment target yet. The goal is to underline evidence-based clinical situations when it is useful to use PWV or phenotypes that either associate with it or include it as one of the distinctive features. Finally, by acknowledging (with progressively robust evidence) that several biomarkers of hemodynamic function and structure related to vascular aging carry distinct information on cardiovascular risk, new research areas in the field are open, and new phenotypes with potential clinical importance can be unveiled.