COVID-19 may accelerate vascular aging in women: key findings
A new international study published in the European Heart Journal reports that infection with SARS-CoV-2 could hasten the loss of elasticity in the walls of blood vessels among women. The increase in arterial stiffness after COVID-19 begins to resemble vascular aging that would typically take several years, particularly in those who experienced more severe illness.
The research team, which includes Mohsen Agharazii and Catherine Fortier from Université Laval and the CHU de Québec – Université Laval research center, examined vascular stiffness in about 2,100 people across 18 countries. The participants were divided into four groups: those who had COVID-19 without hospitalization (mostly milder infections), those hospitalized in standard care units (moderate severity), those admitted to intensive care (severe infection), and a control group of 391 individuals who had never had COVID-19. To assess vascular stiffness, scientists measured pulse wave velocity (PWV) in the aorta—the body’s main artery—using sensors placed on the neck and thigh. A faster PWV indicates stiffer arteries and, with age, is used as a proxy for vascular age.
How the results differed by sex
Participants were tested twice: six months and then twelve months after infection. The standout finding was that women who had COVID-19 showed higher PWV than women in the control group, across all levels of infection severity. Translating the differences into vascular age, the researchers reported roughly a five-year acceleration for those with mild or moderate infection and about a ten-year acceleration for those with severe infection. In contrast, no comparable differences were observed among men.
Why might women be affected differently?
Experts point to immune response differences between the sexes. “The immune reaction against infections is generally stronger in women,” explains lead author Catherine Fortier. While a robust response can help clear infection, this heightened response may trigger more inflammation, potentially causing greater damage to blood vessel walls. SARS-CoV-2 targets receptors present in the inner lining of arteries, so injury to the vascular system can persist even after the acute infection resolves, leaving residual scarring that contributes to stiffness.
What this means for cardiovascular risk and care
One striking finding is that twelve months after infection, the average vascular stiffness in women who had COVID-19 did not return to the level seen in the never-infected group. The question of whether COVID-19–induced vascular changes are permanent remains open, but the data highlight a potential long-term consequence for women’s cardiovascular health. The researchers stress that this represents a new, additional risk factor to consider when assessing a woman’s cardiovascular risk, alongside hypertension, diabetes, cholesterol, and lifestyle factors.
What can be done now?
While more research is needed to determine the permanence of these changes, the study suggests several practical steps. Regular physical activity, a balanced diet, and adherence to prescribed medications (particularly for hypertension) may help mitigate vascular risk. Clinicians may also consider past COVID-19 infection as part of a woman’s cardiovascular risk profile, prompting earlier monitoring and, where appropriate, preventive interventions.
Looking ahead
The international team’s findings call for continued follow-up to understand whether the observed arterial stiffness wanes over longer periods or persists in some individuals. They also emphasize the need to explore targeted strategies to protect vascular health in women following COVID-19, including lifestyle interventions and potentially new clinical guidelines for risk assessment in post-COVID patients.
Bottom line
The study adds to a growing body of evidence that COVID-19 can have lasting effects beyond the acute infection, notably increasing arterial stiffness in women. As researchers seek to determine the duration and reversibility of these changes, incorporating prior infection into cardiovascular risk assessments for women could become an important aspect of preventive care.
