New evidence links COVID-19 to faster vascular aging in women
A large international study published in the European Heart Journal reports that the loss of elasticity in blood vessels accompanying normal aging may be accelerated in women after a COVID-19 infection. The researchers found that arterial stiffness—measured by pulse wave velocity (PWV) in the aorta—appears to increase for women who had COVID-19, with the effect growing stronger with the severity of the infection. In the study, the vascular aging effect was comparable to advancing the clock by 5 years for mild to moderate infections and up to 10 years for severe cases, compared with women who never had COVID-19.
How the study was conducted
The international team examined about 2,100 adults across 18 countries, including three groups who had COVID-19: non-hospitalized individuals (mostly mild cases), those hospitalized in standard care units (moderate severity), and patients admitted to intensive care (severe disease). A control group of 391 participants had never contracted COVID-19. To assess vascular health, researchers measured PWV in the aorta by placing sensors on the neck and thigh, a method that reflects how fast the pressure wave travels along major arteries. PWV was measured twice per participant: at roughly six months and again at about one year after infection.
Key findings: women show higher vascular stiffness after COVID-19
The study found that, unlike men, women who had COVID-19 showed higher PWV values than women in the control group across all three infection severities. The resulting differences corresponded to an estimated 5 years of additional vascular aging for those with mild or moderate infections and about 10 years for those who experienced a severe infection. In men, no significant differences in PWV emerged between the COVID-19 groups and controls at either follow-up point.
Why the effect may be stronger in women
Immune response and inflammation
Experts suggest that women’s typically more robust immune response to infections could play a role. While a strong immune reaction helps fight the virus, it may lead to higher or prolonged inflammation that damages blood vessels, accelerating stiffness.
Endothelial involvement by the virus
The SARS-CoV-2 virus targets receptors abundant in the inner lining of blood vessels. Even after the infection clears, scarring or residual changes in the vascular wall could persist, contributing to increased PWV and higher cardiovascular workload.
Implications for cardiovascular risk and care
Lead author Mohsen Agharazii and co-author Catherine Fortier emphasize that the vascular changes observed at 12 months post-infection were not fully resolved to the level of non-infected peers. While it is not yet known whether this vascular aging is permanent, the findings suggest that a history of COVID-19 should be considered alongside hypertension, diabetes, and cholesterol when assessing a woman’s cardiovascular risk. The authors note that lifestyle factors—regular physical activity, a balanced diet, and adherence to prescribed treatments for hypertension and other risk factors—may help mitigate potential harms.
What this means for the public and clinicians
With a large portion of the population having experienced COVID-19, the study highlights a potential, gender-specific layer to cardiovascular risk. Clinicians may need to factor prior COVID-19 infection into risk assessments for women, especially those with other risk factors. Ongoing follow-up and targeted prevention strategies could be important as researchers seek to determine whether the vascular changes fade, persist, or progress over time.
Bottom line
COVID-19 may accelerate vascular aging in women, increasing arterial stiffness months after infection. While the reversibility of this effect remains uncertain, awareness and proactive cardiovascular care are advised for women who have had COVID-19, particularly after severe illness.
