New research explores why some people are more resilient to vascular ageing

1st October 2026 – by TwinsUK

Researchers from King’s College London are exploring why some people maintain healthier arteries despite having risk factors associated with vascular ageing, introducing the concept of “arterial resilience” as a new way of studying cardiovascular health. 

The expert opinion paper, published in Cardiovascular Research, was co-authored by Dr Marina Cecelja and Professor Claire Steves from TwinsUK, alongside Professor Phil Chowienczyk. 

The researchers propose that looking at resilience — rather than focusing only on factors that increase cardiovascular risk — could provide new insights into why individuals experience different rates of vascular ageing. 

“Arterial ageing does not affect everyone in the same way. The concept of arterial resilience gives us a way to investigate why some individuals appear to maintain healthier arteries despite having similar levels of physiological or genetic risk.” 

— Dr Marina Cecelja, Department of Twin Research, Ageing & Genomic Epidemiology, King’s College London 

What is arterial resilience? 

As we age, the arteries undergo structural and functional changes. These include atherosclerosis, where fatty plaques build up within the arteries, and arteriosclerosis, which involves stiffening of the arterial wall. 

The researchers suggest that cardiovascular research has traditionally focused on identifying and reducing risk factors, but that there is another important question to consider: why do some people remain relatively protected despite exposure to these risks? 

They describe arterial resilience as the ability to maintain better-than-expected arterial health despite exposure to physiological or genetic stressors. 

For example, someone may have elevated blood pressure or a higher genetic risk of arterial stiffness but still have relatively healthy arteries. Understanding what may help protect these individuals could reveal new biological or lifestyle factors linked to healthy vascular ageing. 

Insights from TwinsUK 

The researchers explored the concept using data from more than 2,000 female participants from the TwinsUK cohort, with an average age of around 59 years. 

Arterial stiffness was assessed using carotid-femoral pulse wave velocity (PWV), a widely used measure of arterial stiffness and an established indicator of vascular health. 

The analysis considered blood pressure and genetic risk for arterial stiffness as potential stressors. Measures of arterial resilience showed a strong relationship when either blood pressure or genetic risk was used as the stressor, while blood pressure and genetic risk themselves showed little correlation. 

This suggests that resilience may capture an aspect of vascular health that is not simply explained by an individual’s level of conventional physiological or genetic risk. 

“TwinsUK provides a particularly valuable resource for investigating differences between people in the ageing process. By looking at vascular health alongside physiological and genetic factors, we can begin to ask not only who is at risk, but also what might help some people remain resilient.” 

— Professor Claire Steves, Department of Twin Research, Ageing & Genomic Epidemiology, King’s College London 

Could lifestyle influence resilience? 

The researchers also carried out a preliminary analysis looking at lifestyle factors. 

They found that resilience to arterial stiffening declined with age. However, this decline was smaller among participants with higher Healthy Eating Index scores. 

The finding provides an early indication that lifestyle factors could potentially play a role in maintaining vascular resilience, although the authors emphasise that further research is needed to investigate this relationship. 

A new way of thinking about vascular ageing 

The concept of arterial resilience builds on similar ideas from other areas of ageing research, including cognitive reserve — the ability of some individuals to maintain cognitive function despite underlying pathology. 

The researchers suggest that studying resilience could help identify biological, genetic and environmental factors that contribute to healthier vascular ageing. 

Understanding these protective mechanisms could eventually complement existing approaches to cardiovascular prevention by shifting some attention towards factors that help people maintain good vascular health, rather than focusing solely on factors that increase disease risk. 

However, the authors stress that arterial resilience is still a developing concept and that further research is needed to establish how it should be measured and to identify the mechanisms that underpin it. 

The research was funded by the Centre for Ageing Resilience in a Changing Environment (CARICE) at King’s College London.