Vascular Aging

INN.oral.HEALTH is an sub-study embedded in the Innsbruck Health Promotion Program (INN.HEALTH). The study investigates whether oral health, oral structure, and oral function provide additional information for understanding vascular health in adults from the general population. Cardiovascular and cerebrovascular diseases, such as heart attack and stroke, remain major causes of death and disability. Many risk factors, including blood pressure, blood lipids, blood sugar, smoking, physical activity, sleep, and diet, are already known to influence vascular health. However, oral health may also be related to vascular risk. Conditions such as tooth loss, impaired chewing, reduced tongue strength, or oral disease burden may reflect or contribute to general health and vascular ageing, but their additional value in prevention programs is not yet well understood. The main hypothesis of this study is that a standardized oral structure and function profile can improve the explanation of central arterial stiffness beyond established cardiovascular risk factors and lifestyle-related health metrics (INN.HEALTH study). Central arterial stiffness will be assessed using carotid-femoral pulse wave velocity, a marker of vascular ageing and cardiovascular risk. Participants will undergo a single oral assessment during Visit 4 of the INN.HEALTH study. The assessment includes screening of oral health status, dentition, bite force, tongue pressure, chewing efficiency, chewing and swallowing performance, questionnaires on oral health-related quality of life and food avoidance, and measurement of masseter muscle thickness. The study does not involve any treatment. The results may help clarify whether oral structural and functional markers can contribute to future vascular risk assessment and prevention strategies in the general adult population.

This prospective observational cohort study will enroll adult patients undergoing cardiac surgery at Nanjing First Hospital, Nanjing Medical University. The study will evaluate multidimensional vascular aging markers before surgery and assess their association with postoperative acute kidney injury within 7 days after surgery. No intervention will be assigned by the study protocol, and all perioperative management will follow routine clinical practice.

Cardiovascular diseases pose a serious threat to public health, and their prevalence is on the rise year by year. Vascular aging is an independent risk factor for cardiovascular diseases, and endothelial cell senescence is an early event in vascular aging. Its occurrence can lead to endothelium-dependent vasodilation dysfunction, reduced vascular permeability, and the release of the senescence-associated secretory phenotype (SASP). These vascular pathological changes further damage the vascular media, leading to vascular remodeling and reduced compliance, accelerating the progression of atherosclerosis, and ultimately resulting in cardiovascular diseases such as coronary heart disease and hypertension. Recent research of the investigators has revealed that SNRK, a new member of the AMPK family of cellular energy sensors, plays a key regulatory role in vascular development. Based on this finding, the investigators propose the scientific hypothesis that SNRK responds to both physiological and pathological aging stimuli through differential mechanisms and regulates the process of endothelial cell senescence. In this study, the investigators will explore the correlation between SNRKAS and carotid vascular structure and endothelial function by measuring the levels of the SNRK upstream lncRNA (SNRKAS) in participants' peripheral blood, in conjunction with carotid ultrasound examinations. The findings will provide a solid scientific basis for elucidating new mechanisms underlying the onset and progression of vascular aging and for identifying novel therapeutic targets.

Emerging evidence identifies vascular aging independently predicting cardiovascular events, yet effective clinical interventions remain lacking. Nicotinamide adenine dinucleotide (NAD+) is an essential cofactor whose levels decline with age, and preclinical studies suggest that boosting NAD+ can improve vascular function and structure. Preliminary clinical studies in healthy older adults indicate that supplementation with NAD+ precursors, such as nicotinamide riboside(NR) or nicotinamide mononucleotide (NMN), can reduce arterial stiffness as measured by pulse wave velocity (PWV). However, whether NAD+ supplementation can improve vascular endothelial function and exert anti-stiffening effects in patients who have already developed measurable arterial stiffness remains unknown. Based on this evidence, the investigator hypothesize that the Coenzyme I for Injection will reverse vascular aging in older adults with established arterial stiffening.

Early vascular aging has its origins in fetal and neonatal life. The NEOVASC clinical trial aims to determine the effects of an exclusive human milk diet in extremely preterm infants on long-term cardiovascular health.