Proinflammation: the key to arterial aging

•Arterial aging causes chronic arterial inflammation.•Age-associated arterial wall chronic inflammation drives arterial cell phenotypic shifts and adverse arterial wall remodeling.•The inflamed arterial wall in advancing age confers the major risk for hypertension and atherosclerosis.•Interventions to suppress chronic arterial inflammation may beneficially impact age-associated arterial diseases in our society.

Arterial aging is the major contributing factor to increases in the incidence and prevalence of cardiovascular disease, due mainly to the presence of chronic, low-grade, ‘sterile’ arterial inflammation. Inflammatory signaling driven by the angiotensin II cascade perpetrates adverse age-associated arterial structural and functional remodeling. The aged artery is characterized by endothelial disruption, enhanced vascular smooth muscle cell (VMSC) migration and proliferation, extracellular matrix (ECM) deposition, elastin fracture, and matrix calcification/amyloidosis/glycation. Importantly, the molecular mechanisms of arterial aging are also relevant to the pathogenesis of hypertension and atherosclerosis. Age-associated arterial proinflammation is to some extent mutable, and interventions to suppress or delay it may have the potential to ameliorate or retard age-associated arterial diseases.