Dismantling Anti-Ageing Medicine: Why Age-Relatedness of Cardiovascular Disease is Proof of Robustness Rather Than of Ageing-Associated Vulnerability

Abstract

Ageing is perceived to be the common culprit behind the most prevalent noncommunicable chronic diseases (NCD) such as cardiovascular disease (CVD). Treating ageing as a means to prevent its downstream pathologies has become the logical extension of this idea, and the defining criterion of anti-ageing medicine (evidence-based early detection, prevention, and treatment of age-related diseases). Challenging the underlying rationale, we here argue that the disease's late-in-life occurrence is proof of a genetically conserved robustness that helps us resist disease long enough for it to masquerade as a consequence of living long rather than of living wrong. Robustness is an acknowledged hallmark phenomenon of all complex systems (while there exists no universally adopted definition, a hallmark of complex systems is that they consist of many networked components whose interactions may give rise to system behaviours which cannot be derived or predicted from a reductionist knowledge of the interacting parts, even if this knowledge is complete) and a key concept in the complexity sciences (a relatively new branch of science that attempts to find and understand the common mechanisms and patterns shared by all complex systems). To reconceptualise the age-relatedness of chronic diseases in this sense has important implications for medical research and practice. The goal of our essay is to open a discussion that may enhance the overall understanding of robustness and prevent a misguided redirection of funding away from established disease specific research and towards anti-ageing medicine. This essay is timely, as the forthcoming 11 th version of the International Classification of Diseases (ICD) will be the first to recognise ageing as a condition, thereby legitimising anti-ageing medical research. On a more pragmatic note, and for the benefit of people alive today, we propose a practical strategy to remedy the mismatch between heritable robustness and the lifestyle challenges that gradually overwhelm it.

Case Report: Supernormal Vascular Aging in Leningrad Siege Survivors

“…Healthy longevity can be assumed as a chance occurrence of an ideal congruence between hereditary resistance and practiced lifestyle ( 33 ). Presentation of these patients suggests that in certain cases, cumulative effect of favorable lifestyle patterns (behavioral and socioeconomical) and absence of severe genetic risks could be sufficient to mitigate damaging exposures sustained earlier in life.…”

Cardiovascular prevention in childhood: a consensus document of the Italian Society of Cardiology Working Group on Congenital Heart Disease and Cardiovascular Prevention in Paediatric Age

“…It is also a marker of early atherosclerosis in young individuals 111 . It is interesting to note that, in a philosophical way, some authors think that the relationship between cardiovascular diseases and age is an unavoidable effect of living longer and, as such, proof of robustness rather than something we should cope with 112 . A typical example of EVA is seen in children with high blood pressure.…”

“…111 It is interesting to note that, in a philosophical way, some authors think that the relationship between cardiovascular diseases and age is an unavoidable effect of living longer and, as such, proof of robustness rather than something we should cope with. 112 A typical example of EVA is seen in children with high blood pressure. They show an accelerated biological development, their biological age being 4-5 years older than their real age.…”

How to Slow down the Ticking Clock: Age-Associated Epigenetic Alterations and Related Interventions to Extend Life Span

“…As of the year 2021, aging is considered both an intriguing process that research attempts to understand and a universal burden that the scientific community and the industry seek to intervene with. Currently, various theories have been put forward as to how we age, which physical alterations occur during aging and how we could substantially increase healthy life span or even maximal life span [1][2][3]. In 2013, a comprehensive review by Lopez-Otin and colleagues proposed a detailed framework incorporating nine hallmarks of aging to characterize this complex process [4].…”