Vascular memory and the erasability spectrum: reframing reversible and irreversible vascular aging

Vascular aging integrates cardiometabolic stress into persistent molecular, cellular, and structural injury, yet its variable reversibility remains poorly explained. We propose a vascular memory framework in which prior stress is stored across epigenetic, immune, mitochondrial-redox, senescent, and matrix substrates and recalled as vascular dysfunction. Their differing erasability may guide provisional endotyping and therapeutic selection, distinguish modifiable from persistent injury, and emphasize earlier, substrate-matched intervention before consolidation limits reversibility.

The author thanks the SRM Medical College Hospital & Research Centre for their constant support and encouragement. The authors gratefully acknowledge the financial support by SRM Medical College Hospital & Research Centre, Faculty of Medicine and Health Sciences, SRMIST, Kattankulathur, for bearing the defrayed costs of publishing this article. Open access funding provided by SRM Institute of Science and Technology for SRMIST – Medical & Health Sciences.

Department of Biochemistry, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India Rooban Sivakumar, K. Vinodhini The authors declare no competing interests. During the preparation of this work, the author(s) used Quillbot to improve writing language.

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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. Sivakumar, R., Senghor, K.A.A. & Vinodhini, V.M. Vascular memory and the erasability spectrum: reframing reversible and irreversible vascular aging. npj Aging (2026). https://doi.org/10.1038/s41514-026-00526-y DOI: https://doi.org/10.1038/s41514-026-00526-y