Objective:

To investigate how hypertension, coronary artery disease, and heart failure with preserved ejection fraction serve as accelerators of vascular aging and their implications for perioperative decision support, particularly in risk stratification.

Key Findings:

• Vascular age can be quantitatively assessed through cardiovascular risk markers, with pulse wave velocity (PWV) being a reliable predictor of mortality and surgical complications.
• Conditions like hypertension and coronary artery disease can advance vascular age significantly, leading to increased perioperative risks and complications.
• Patients with well-controlled hypertension may have a vascular age 5-10 years older, while those with poorly controlled hypertension may see a shift of 10-15 years, impacting surgical outcomes.

Interpretation:

The mismatch between vascular age and chronological age can explain why younger patients with comorbidities experience complications typically seen in older individuals, suggesting a need for integrating vascular age into risk assessments for surgical procedures.

Limitations:

• Overlap of comorbid conditions may complicate the reliability of vascular age estimates, making it challenging to determine true vascular age.
• Current assessments may not fully capture the complexity of vascular aging mechanisms, necessitating further research.

Conclusion:

Understanding vascular age in relation to chronological age is crucial for better perioperative risk stratification and management of patients with cardiovascular comorbidities.