Chronological age causes structural and functional vascular deterioration and is a well‐established risk factor for the development of cardiovascular diseases, leading to more than 40% of all deaths in the elderly. The etiology of vascular aging is complex; a significant impact arises from impaired cholesterol homeostasis. Cholesterol level is balanced through synthesis, uptake, transport, and esterification, the processes executed by multiple organelles. Moreover, organelles responsible for cholesterol homeostasis are spatially and functionally coordinated instead of isolated by forming the membrane contact sites. Membrane contact, mediated by specific protein–protein interaction, pulls opposing organelles together and creates the hybrid place for cholesterol transfer and further signaling. The membrane contact‐dependent cholesterol transfer, together with the vesicular transport, maintains cholesterol homeostasis and has intimate implications in a growing list of diseases, including vascular aging‐related diseases. Here, we summarized the latest advances regarding cholesterol homeostasis by highlighting the membrane contact‐based regulatory mechanism. We also describe the downstream signaling under cholesterol homeostasis perturbations, prominently in cholesterol‐rich conditions, stimulating age‐dependent organelle dysfunction and vascular aging. Finally, we discuss potential cholesterol‐targeting strategies for therapists regarding vascular aging‐related diseases.This article is categorized under:
Cardiovascular Diseases > Molecular and Cellular Physiology