Carotid Disease and Ageing: A Literature Review on the Pathogenesis of Vascular Senescence in Older Subjects

Abstract

Aging is a natural process that affects all systems of the human organism, leading to its inability to adapt to environmental changes. Advancing age has been correlated with various pathological conditions, especially cardiovascular and cerebrovascular diseases. Carotid artery (CA) is mainly affected by age-induced functional and morphological alterations causing atheromatous disease. The evolvement of biomedical sciences has allowed the elucidation of many aspects of this condition. Symptomatic carotid disease (CD) derives from critical luminar stenosis or eruption of an atheromatous plaque due to structural modifications of the vessels, such as carotid intima-media thickening. At a histologic level, the aforementioned changes are mediated by elastin fragmentation, collagen deposition, immune cell infiltration, and accumulation of cytokines and vasoconstrictors. Underlying mechanisms include chronic inflammation and oxidative stress, dysregulation of cellular homeostatic systems, and senescence. Thus, there is an imbalance in components of the vessel wall, which fails to counteract exterior stress stimuli. Consequently, arterial relaxation is impaired and atherosclerotic lesions progress. This is a review of current evidence regarding the relationship of aging with vascular senescence and CD. A deeper understanding of these mechanisms can contribute to the production of efficient prevention methods and targeted therapeutic strategies.

A Comparative Study of the Right and Left Carotid Arteries in Relation to Age for Patients With Diabetes and Hypertension

“…These changes may be related to the increase in shear stress in the left side versus the right side. 10 Many of the measured parameters obtained from the right ICA were significantly different from the left ICA in the young age group, and this is 5.12 ± 1.12 5.73 ± 0.39 BMI = body mass index; DM = diabetes mellitus; FBS = fasting blood sugar; HT = hypertension; SD = standard deviation. thought to be due to the different anatomic origins of the right CCA and left CCA.…”

“…These changes may be related to the increase in shear stress in the left side versus the right side. 10 Many of the measured parameters obtained from the right ICA were significantly different from the left ICA in the young age group, and this is thought to be due to the different anatomic origins of the right CCA and left CCA. The preferential occurrence of early and potential pathology in the left carotid system could be due to hemodynamic effects related to the anatomy of the carotid arteries.…”

Ex Vivo Study Using Diffusion Tensor Imaging to Identify Biomarkers of Atherosclerotic Disease in Human Cadaveric Carotid Arteries

“… 49 The imbalance of microstructural components in the vessel wall, governed by elastin fragmentation, immune cell infiltration, cytokine accumulation and collagen deposition, coupled with chronic inflammation, dysregulation of cellular homeostatic systems and senescence inhibits arterial relaxation, changing the mechanical environment and ultimately allowing for atherosclerotic lesion progression. 50 Therefore, it is possible that the significant drop in FA present in all subjects, regardless of anatomical location or healthy or diseased ranking, could be an early indicator for early vessel wall degradation.…”

Non-Fasting Hypertriglyceridemia Burden as a Residual Risk of the Progression of Carotid Artery Stenosis

“…It is well known that advanced age itself is related to pathogenic mechanisms of the development of carotid artery atherosclerosis in multiple ways [ 7 ]. In the present study, however, patients in the carotid stenosis progression group were significantly younger than those in the non-progression group on univariate analyses.…”