Overview
A new international study published in the European Heart Journal reports that COVID-19 may accelerate vascular aging in women. The research suggests that the loss of elasticity in the body’s blood vessels that typically accompanies aging could be hastened after a SARS-CoV-2 infection. Depending on the severity of the infection, this vascular stiffening could equate to roughly 5 to 10 extra years of aging, a finding that did not appear among men in the study.
Study Design and Methods
The researchers examined the vascular health of about 2,100 adults across 18 countries. Participants were divided into three groups based on their COVID-19 experience: those who were not hospitalized (mostly mild infections), those hospitalized in regular wards (moderate severity), and those admitted to intensive care (severe infection). A separate control group of 391 individuals had never contracted COVID-19.
To assess vascular stiffness, scientists measured the speed at which the pulse wave travels along the aorta—the body’s main artery—using sensors placed at the neck and thigh. This measure, known as pulse wave velocity (PWV), rises with age and serves as a proxy for vascular age. The team conducted two assessments for each participant: six months and then twelve months after infection.
Key Findings: Women More Affected Than Men
The most striking result was observed in women. Across all three COVID-19 groups, the PWV was higher than in the non-infected control group six and twelve months after infection, indicating stiffer arteries. The degree of aging-like stiffening corresponded to about five extra years for those with mild or moderate infection and about ten extra years for those who had severe infection. Remarkably, the study found no comparable difference among men.
Lead investigators Mohsen Agharazii and Catherine Fortier, affiliated with the Université Laval and the CHU de Québec–Université Laval, explained that this sex difference likely stems from the immune response. Women often mount a more robust immune reaction to infections, which can be protective yet may also trigger more inflammation that damages the vascular lining over time.
Why Vascular Stiffness After COVID-19 Matters
The inner lining of blood vessels expresses receptors that the SARS-CoV-2 virus uses to enter cells. Even after acute infection subsides, residual scarring in the vessel walls can persist and contribute to increased PWV. Greater arterial stiffness forces the heart to work harder, and it can elevate blood pressure, potentially affecting the heart, brain, and kidneys over the long term.
Clinical Implications and Lifestyle Considerations
While the researchers did not conclude that infection-induced vascular stiffness is permanent, the findings imply that women who have had COVID-19 should have their cardiovascular risk assessed in light of this history—similar to how hypertension, cholesterol, and diabetes are considered. Lifestyle and medical management may help mitigate risk: regular physical activity, a balanced diet, blood pressure control, and adhering to prescribed medications can all reduce cardiovascular risk linked to vascular aging.
Experts emphasize that further research is needed to determine whether these vascular changes are reversible in all cases and to identify which women remain at higher risk. In the meantime, clinicians and patients should recognize prior COVID-19 infection as a potential contributor to cardiovascular risk and incorporate it into risk stratification and prevention strategies.
Bottom Line
This international study adds to growing evidence that COVID-19 can leave lasting marks on vascular health, with women appearing more susceptible to post-infection arterial stiffening. The findings underscore the importance of cardiovascular monitoring after infection and reinforce the value of healthy lifestyle choices to counteract potential acceleration of vascular aging.
