CV Ageing Beyond Frailty: Insulin resistance, Senescence, Stiffness & the Ageing Heart

Geriatric cardiology has long centered on managing frailty and multimorbidity in older patients, but this focus stops short of the biology driving cardiovascular ageing itself. This Research Topic goes one level deeper - into the cellular and molecular processes of cardiac and vascular ageing - and asks whether senescence, epigenetic drift, and inflammageing are targetable mechanisms rather than inevitable consequences of time. Rather than treating ageing as a backdrop to disease management, the topic reframes it as a modifiable pathophysiological process, connecting cellular senescence to the metabolic, endocrine, and haemodynamic pathways long central to cardiovascular medicine - insulin resistance, aldosterone-driven remodeling, thyroid-hormone signalling, and arterial stiffness - and asks how each intersects with, and potentially accelerates, cardiac ageing.The rationale for this topic is timely. Senolytic combinations such as dasatinib and quercetin, growth factors like GDF-11, insulin sensitizing agents and epigenetic reprogramming strategies are moving from preclinical promise toward serious clinical interest, while biological age measurement is increasingly being incorporated into clinical trial design as a primary endpoint. At the same time, established cardiovascular risk modifiers - insulin resistance and hyperinsulinemia, aldosterone excess, and thyroid dysfunction - are being re-examined as accelerants of biological cardiac ageing rather than as independent risk factors, opening a productive dialogue between ageing biology and classical cardiovascular pathophysiology.This Research Topic is explicitly distinct from the existing Multimorbidity and Frailty Research Topic, which addresses the clinical management of older, multimorbid patients. Here, the emphasis is on the underlying cellular biology and the open question of reversibility, rather than on downstream clinical management strategies.Scope - we welcome contributions addressing:o Basic and translational research on cardiac and vascular cellular senescenceo Telomere attrition and its relationship to cardiovascular ageingo Mitochondrial healtho Epigenetic ageing clocks and their application to cardiovascular risk predictiono Inflammageing and its mechanistic links to cardiac and vascular dysfunctiono Arterial stiffness as a marker and driver of cardiovascular ageingo Metabolic and endocrine drivers of cardiac ageing, including insulin resistance/hyperinsulinemia and aldosterone-mediated structural remodelingo Thyroid hormone signaling and its relative contribution to age-related cardiac dysfunction and heart failureo Clinical studies comparing biological versus chronological age as modifiers of cardiovascular risko Emerging interventions targeting senescence and ageing biology (e.g., senolytics, GDF-11, insulin sensitizing agents, epigenetic reprogramming) in cardiovascular contextsWe welcome Original Research, Review, Hypothesis and Theory, Mini Review, and Translational Studies articles from researchers spanning basic ageing biology, vascular biology, and clinical cardiology, including work that connects cellular senescence to heart failure and coronary artery disease pathophysiology. Topic editors: Serafino Fazio, Flora Affuso Source: https://www.frontiersin.org/research-topics/84248/cv-ageing-beyond-frailty-insulin-resistance-senescence-stiffness-the-ageing-heart