Covid Could Be Quietly Aging Your Arteries by Five Years

COVID-19 may be silently accelerating the aging of our arteries, with women facing the sharpest impact.

A major international study found that even mild Covid infections can stiffen blood vessels as if they had aged five extra years, raising long-term risks of heart attacks and strokes.

Covid Infection May Accelerate Vascular Aging

A Covid infection may cause blood vessels to age by about five years, with the effect most pronounced in women, according to new research published in the European Heart Journal.^[1]

Normally, arteries and veins stiffen gradually as part of the natural aging process. This study, however, suggests that Covid speeds up that change. Stiffer blood vessels are a concern because they raise the risk of cardiovascular problems, including stroke and heart attack.

The work was led by Professor Rosa Maria Bruno of Université Paris Cité in France. She explained: “Since the pandemic, we have learned that many people who have had Covid are left with symptoms that can last for months or even years. However, we are still learning what’s happening in the body to create these symptoms.

“We know that Covid can directly affect blood vessels. We believe that this may result in what we call early vascular aging, meaning that your blood vessels are older than your chronological age and you are more susceptible to heart disease. If that is happening, we need to identify who is at risk at an early stage to prevent heart attacks and strokes.”

How the Study Was Conducted

The study followed 2,390 participants from 16 countries (Austria, Australia, Brazil, Canada, Cyprus, France, Greece, Italy, Mexico, Norway, Turkey, UK and US) recruited between September 2020 and February 2022. Participants were divided into groups: those who had never had Covid, those with a recent infection but no hospitalization, those hospitalized on a general ward, and those admitted to intensive care.

To measure vascular aging, researchers used a device that tracks how quickly a blood pressure wave travels between the carotid artery in the neck and the femoral arteries in the legs. This measurement, known as carotid-femoral pulse wave velocity (PWV), indicates vessel stiffness. Higher PWV means the arteries are stiffer and therefore considered older in biological terms. Each participant was tested at six months after infection and again at 12 months.

Researchers assessed each person’s vascular age with a device that measures how quickly a wave of blood pressure travels between the carotid artery (in the neck) and femoral arteries (in the legs), a measure called carotid-femoral pulse wave velocity (PWV). The higher this measurement, the stiffer the blood vessels and the higher the vascular age of a person. Measurements were taken six months after Covid infection and again after 12 months.

Demographic information was also collected, including sex, age, and other cardiovascular risk factors that could influence results.

Covid’s Lasting Impact on Arteries

After taking these factors into consideration, researchers found that all three groups of patients who had been infected with Covid, including those with mild Covid, had stiffer arteries, compared to those who had not been infected. The effect was greater in women than in men and in people who experienced the persistent symptoms of long Covid, such as shortness of breath and fatigue.

The average increase in PWV in women who had mild Covid was 0.55 meters per second, 0.60 in women hospitalized with Covid, and 1.09 for women treated in intensive care. Researchers say

an increase of around 0.5 meters per second is “clinically relevant” and equivalent to aging around five years, with a 3% increased risk of cardiovascular disease, in a 60-year-old woman.

People who had been vaccinated against Covid generally had arteries that were less stiff than people who were unvaccinated. Over the longer term, the vascular aging associated with Covid infection seemed to stabilize or improve slightly.

Why Covid Damages Blood Vessels

Professor Bruno said: “There are several possible explanations for the vascular effects of Covid. The Covid-19 virus acts on specific receptors in the body, called the angiotensin-converting enzyme 2 receptors, that are present on the lining of the blood vessels. The virus uses these receptors to enter and infect cells. This may result in vascular dysfunction and accelerated vascular aging. Our body’s inflammation and immune responses, which defend against infections, may be also involved.

“One of the reasons for the difference between women and men could be differences in the function of the immune system. Women mount a more rapid and robust immune response, which can protect them from infection. However, this same response can also increase damage to blood vessels after the initial infection.

Addressing Accelerated Vascular Aging

“Vascular aging is easy to measure and can be addressed with widely available treatments, such as lifestyle changes, blood pressure-lowering, and cholesterol-lowering drugs. For people with accelerated vascular aging, it is important to do whatever is possible to reduce the risk of heart attacks and strokes.”

Professor Bruno and her colleagues will continue to follow the participants over the coming years to establish whether the accelerated vascular aging they have found leads to an increased risk of heart attacks and strokes in the future.

Expert Reactions and Editorial Insights

In an accompanying editorial,^[2] Dr. Behnood Bikdeli from Harvard Medical School, Boston, USA and colleagues said: “Although the acute threat of the COVID-19 pandemic has waned, a new challenge emerged in its aftermath: post-acute COVID-19 syndrome. Defined by the World Health Organization as symptoms appearing three months post-infection and lasting at least two months, studies suggest that up to 40% of initial COVID-19 survivors develop this syndrome.

“This large, multicenter, prospective cohort study enrolled 2390 participants from 34 centers to investigate whether arterial stiffness, as measured by PWV, persisted in individuals with recent COVID-19 infection. […] sex-stratified analyses revealed striking differences: females across all COVID-19-positive groups had significantly elevated PWV, with the highest increase (+1.09 m/s) observed in those requiring ICU admission.

“The CARTESIAN study makes the case that COVID-19 has aged our arteries, especially for female adults. The question is whether we can find modifiable targets to prevent this in future surges of infection, and mitigate adverse outcomes in those afflicted with COVID-19-induced vascular aging.”

References:

1. “Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study” by Rosa Maria Bruno, Smriti Badhwar, Leila Abid, Mohsen Agharazii, Fabio Anastasio, Jeremy Bellien, Otto Burghuber, Luca Faconti, Jan Filipovsky, Lorenzo Ghiadoni, Cristina Giannattasio, Bernhard Hametner, Alun D Hughes, Ana Jeroncic, Ignatios Ikonomidis, Mai Tone Lonnebakken, Alessandro Maloberti, Christopher C Mayer, Maria Lorenza Muiesan, Anna Paini, Andrie Panayiotou, Chloe Park, Chakravarthi Rajkumar, Carlos Ramos Becerra, Bart Spronck, Dimitrios Terentes-Printzios, Yesim Tuncok, Thomas Weber, Pierre Boutouyrie, the CARTESIAN Investigators, Herta Almhofer, Kathen Danninga, Margot Algner, Martin Wernhart, Thomas Weber, Bernhard Hametner, Christopher C Mayer, Otto Burghuber, Mohammad Azizzadeh, Marie-Kathrin Breyer, Luiz Bortolotto, Jose Fernando Vilela-Martin, Rogério Toshiro Passos Okawa, Jaqueline Lyrio Bermudes Okawa, Weimar Kunz Sebba Barroso, Emmanuel Gomes Ciolac, Vanessa Teixeira do Amaral, Bianca Fernandez, Rémi Goupil, Mohsen Agharazii, Catherine Fortier, Andrie G Panayiotou, Galatia Photiou, Jan Filipovský, Otto Mayer, Jitka Seidlerová, Petr Pazdiora, Jana Hirmerová, Lucie Šustková, Simona Bílková, Július Gelžinský, Veronika Kordíková, Štěpán Mareš, Renata Cífková, Peter Wohlfahrt, Jana Kavalírová, Rosa Maria Bruno, Pierre Boutouyrie, Hakim Khettab, Junior Justin, Diego Moriconi, Saverio Fabbri, Jean Sebastien Hulot, Antoine Fayol, Marie Courbebaisse, Beatrice Parfait, David Lebeaux, Gérard Friedlander, Jeremy Bellien, Robinson Joannides, Michele Iacob, Anne-Marie Leroi, Athanase Benetos, Ioannis Georgiopoulos, Dimitrios Terentes-Printzios, Georgia Christopoulou, Konstantinos Tsioufis, Vasiliki Gardikioti, Charalambos Vlachopoulos, Ignatios Ikonomidis, Vaia Lambadiari, Alkaternini Kountouri, Konstantinos Katogiannis, Ana Jerončić, Mario Podrug, Mirela Pavičić-Ivelja, Pjero Koren, Maria Lorenza Muiesan, Anna Paini, Massimo Salvetti, Marco Cacciatore, Giacomo Pucci, Fabio Anastasio, Elisa Scarnecchia, Cristina Giannattasio, Maloberti Alessandro, Michela Algeri, Antonella Moreo, Chiara Tognola, Andrea Grillo, Bruno Fabris, Stella Bernadi, Matteo Rovina, Giuliano Di Pierro, Lorenzo Ghiadoni, Sabina Armenia, Elisabetta Bianchini, Luca Zanoli, Pietro Castellino, Arturo Montineri, Alice Sciuto, Davide Grassi, Jolita Badariene, Ligita Ryliskyte, Agne Laucyte-Cibulskiene, Ligita Jancoriene, Kristina Ryliskiene, Agne Juceviciene, Milda Kovaite, Laura Balkeviciene, Carlos G Ramos-Becerra, Guillermos Alanis-Sánchez, Pedro Martinez-Ayala, Ernesto G Cardona-Muñóz, David Cardona-Muller, Mai Tone Lonnebakken, Caroline Annette Berge, Lucimere Bohn, José Oliveira, Emilia Alves, Simao Pedro Costa, Telmo Pereira, Armando Caseiro, Fábio Lira, Maria Rosa Bernal López, María Isabel Ruiz Moreno, Ricardo Gómez Huelgas, Almudena Lopez Sampalo, Jaime Sanz Canovas, Victor Antonio Vargas Cancela, Lidia Cobos Palacios, Juan José Mancebo Sevilla, Arzu Nazlı Zeka, Ebru Özpelit, Canet İncir, Mustafa M Barış, Yeşim Tunçok, Ali Canturk, Hasan Can Cimilli, Leila Abid, Salem Abdessalem, Selma Charfeddine, Amine Bahloul, Rania Hammami, Mahdi Walha, Alun Hughes, Chloe Park, Alexandra Jamieson, Philip J Chowienczyk, Luca Faconti, Bushra Farukh, Riaz Akhtar, Alena Shantsila, Gregory Lip, Alvaro N Gurovich, Manuel Gomez, Lee Stoner, Michelle Meyer, Erik Hanson, Gabriel Zieff, Patricia Pagan Lassalle and Lauren Bates, 17 August 2025, European Heart Journal.
   DOI: 10.1093/eurheartj/ehaf430
2. “COVID-19 and vascular ageing: an accelerated yet partially reversible clock?” by Syed Bukhari, Marie D Gerhard-Herman and Behnood Bikdeli, 17 August 2025, European Heart Journal.
   DOI: 10.1093/eurheartj/ehaf590

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