After Covid, arteries undergo accelerated aging. What are the consequences?

During the COVID pandemic, it was observed that the coronavirus causes acute cardiovascular complications. With long or persistent forms of the disease, could there be long-term effects on the vascular system?

Arterial aging Over time, arteries lose the elasticity that allows them to absorb and transmit pressure variations caused by the normal contractions of the heart, which is a muscle. This stiffening process, which increases the risk of heart attack or stroke, is one of the natural effects of aging.
An international study investigated the possible long-term impact of Covid infection on the arteries. To do this, the researchers used a reference method for measuring arterial elasticity, which is not a routine test. It involves using a sensor at two known distances (carotid artery and femoral artery) to record the speed at which the pressure wave (pulse wave velocity) travels through the arteries, which is known to be higher when the vessels are stiffer.

Study results The 2,390 study participants were recruited from 18 countries and divided into four groups: seronegative subjects, i.e., those who had not been infected in the previous six months and who constituted the normal group (also known as control subjects); patients who had developed a mild form of COVID-19 that did not require hospitalization; patients hospitalized for COVID-19 in a conventional medical ward; and patients with severe COVID-19 who were placed in intensive care units.
The examination was performed six months and then twelve months after the Covid episode. The results, published in the journal of the European Society of Cardiology, show that after Covid, pulse wave velocity is significantly increased compared to control subjects whose values are normal for their age and who therefore have less flexible arteries.
In these infected patients, including the mild cases group, the velocities are higher than in seronegative participants. The phenomenon is particularly pronounced in women and in people suffering from long Covid symptoms, such as fatigue and shortness of breath.

These values can be used to estimate the age of the arteries. While in men the values are slightly increased or unchanged, in women who have had a mild form of Covid, the arteries have undergone the equivalent of an average aging of 5 years. As for patients admitted to intensive care, their vascular age has increased by ten years! There is no continuous increase in stiffness in the three groups of infected patients, but there is a very significant difference in the most severe cases.

Although not pathological, blood pressure is also higher in former Covid patients, whereas it is normal in the control group: approximately 10 mm Hg higher, with 120/70 mm Hg in the control group and 130/80 mm Hg after Covid. These figures place these individuals in the "high blood pressure" category as defined by the European Guidelines. There is concern that if the phenomenon persists or even worsens over time, infected individuals may develop hypertension in the short or long term due to the increased stiffness of their arteries induced by Covid infection.
Perhaps some patients were predisposed to developing high blood pressure, and Covid precipitated the onset of the condition. Somewhat reassuringly, the same test performed twelve months after infection reveals that the phenomenon of Covid-related vascular aging improves, without however returning to normal. The authors naturally wish to continue their study in order to assess the future of these patients and monitor their cardiovascular health. But why are women more affected? In the absence of experimental studies formally demonstrating the mechanism of this effect, several explanations have been put forward to explain the impact of Covid on the age of our arteries: Since the beginning of the pandemic, we have known that the Covid virus directly infects the endothelial cells that line the blood vessels and, being in contact with the blood, cause venous thrombosis: phlebitis and pulmonary embolisms, and more rarely arterial thrombosis. Inflammation and the immune response could certainly be involved, with a stronger response to infection in women, which could be responsible for more pronounced arterial aging. We also know that long Covid is more common in women, and the fact that they are in their fifties (perimenopause) could be an important factor.

So, what can be done? This study highlights a new category of people at risk of developing high blood pressure: those who have had Covid, especially if they have symptoms that persist over time. As this high blood pressure has not yet developed, we can try to prevent it from occurring.

To do this: - Don't worry too much... - Monitor your blood pressure regularly, or have it monitored (advice that applies to everyone) - Check for other risk factors such as smoking, diabetes, or high cholesterol, and manage them if necessary - Eat less salt, more fruit and vegetables, and walk 7,000 steps a day. - If your blood pressure continues to rise despite these lifestyle changes, you will need medication.

Conclusion Among other things, COVID-19 has damaged the arteries, particularly in women. An increased risk of developing high blood pressure has been identified. With this in mind, it is important to take appropriate measures to prevent complications such as heart attacks and strokes, which are largely preventable.


Reference: Bruno R. M. et al: Accelerated vascular aging after COVID-19 infection: the CARTESIAN study.
European Heart Journal (2025) 00, 1–14 - https://doi.org/10.1093/eurheartj/ehaf430 Keywords: Cardiovascular prevention, COVID, vascular damage, arterial stiffness, high blood pressure.