Figure 1.

Etiology of vascular aging based on genomic instability as a causal factor. Classical and unidentified risk factors contribute to various types of DNA lesions. Unrepaired lesions accumulating during life lead to a growing set of pathophysiological changes that, either independently or in mutual interaction, lead to progressive vascular aging. The putative role of transcriptional problems or mutations herein needs to be established. The survival response may have beneficial (increased Nrf2-regulated antioxidants) as well as detrimental (decreased IGF-1 signaling, pro-inflammatory status) effects (see text and Ref. [8]).