The prevalence of centenarians, people who lived 100 years and longer, is steadily growing in the last decades. This exceptional longevity is based on multifaceted processes influenced by a combination of intrinsic and extrinsic factors such as sex, (epi-)genetic factors, gut microbiota, cellular metabolism, exposure to oxidative stress, immune status, cardiovascular risk factors, environmental factors, and lifestyle behavior. Epidemiologically, the incidence rate of cardiovascular diseases is reduced in healthy centenarians along with late onset of age-related diseases compared with the general aged population. Understanding the mechanisms that affect vascular ageing in centenarians and the underlying factors could offer valuable insights for developing strategies to improve overall healthy life span in the elderly. This review discusses these key factors influencing vascular ageing and how their modulation could foster healthy longevity.

CIBER de Diabetes y Enfermedades Metabólicas Asociadas Instituto de Salud Carlos 3 Madrid Spain

Clinical Pharmacology Unit AP HP Hôpital Européen Georges Pompidou Paris France

Department for Biomedical Research University for Continuing Education Krems Krems Austria

Department of Biophysics School of Medicine Yeditepe University Istanbul Türkiye

Department of Cardiology 1 Coronary and Peripheral Vascular Disease University of Münster Münster Germany

Department of Internal Medicine Erasmus University Rotterdam Rotterdam Netherlands

Department of Internal Medicine University of Košice Košice Slovakia

Department of Medical Biology School of Medicine Yeditepe University Istanbul Türkiye

Department of Medical Genetics 3rd Faculty of Medicine Charles University Prague Czechia

Department of Sport Exercise and Health Division of Sport and Exercise Medicine University of Basel Basel Switzerland

Department of Sports Sciences at Serres Aristotle University of Thessaloniki Thessaloniki Greece

Endocrinology Diabetes and Nutrition Group Institut de Recerca SANT PAU Barcelona Spain

Institut d'Investigació Biomèdica de Girona Girona Spain

Institute of Life and Earth Sciences Heriot Watt University Edinburgh UK

Laboratory of Physiopharmacology University of Antwerp Antwerp Belgium

Menzies Institute for Medical Research University of Tasmania Hobart Australia

Molecular Pathology and Therapeutic of Ischemic and Atherothrombotic Diseases Institute de Recerca Sant Pau Barcelona Spain CIBERCV Instituto de Salud Carlos 3 Madrid Spain

Russian Gerontology Research and Clinical Centre Pirogov Russian National Research Medical University Moscow Russia

School of Kinesiology University of Michigan Ann Arbor MI USA

School of Nursing Psychotherapy and Community Health Dublin City University Dublin Ireland

School of Sport and Health Sciences Cardiff Metropolitan University Cardiff UK

Université Paris Cité INSERM Paris Cardiovascular Research Center PARCC Paris France

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