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Review
. 2020 Aug 6;7(3):29.
doi: 10.3390/jcdd7030029.

The Importance of Telomere Shortening for Atherosclerosis and Mortality

Wolfgang Herrmann  1 , Markus Herrmann  2
Affiliations
Review

The Importance of Telomere Shortening for Atherosclerosis and Mortality

Wolfgang Herrmann et al. J Cardiovasc Dev Dis. .

Abstract

Telomeres are the protective end caps of chromosomes and shorten with every cell division. Short telomeres are associated with older age and adverse lifestyle factors. Leucocyte telomere length (LTL) has been proposed as a biomarker of biological age. The shortening of LTL with age is the result of the end-replication problem, environmental, and lifestyle-related factors. Epidemiologic studies have shown that LTL predicts cardiovascular disease, all-cause mortality, and death from vascular causes. Age appears to be an important co-variate that explains a substantial fraction of this effect. Although it has been proposed that short telomeres promote atherosclerosis and impair the repair of vascular lesions, existing results are inconsistent. Oxidative stress and chronic inflammation can both accelerate telomere shortening. Multiple factors, including homocysteine (HCY), vitamin B6, and vitamin B12 modulate oxidative stress and inflammation through direct and indirect mechanisms. This review provides a compact overview of telomere physiology and the utility of LTL measurements in atherosclerosis and cardiovascular disease. In addition, it summarizes existing knowledge regarding the impact of oxidative stress, inflammation, HCY, and B-vitamins on telomere function.

Keywords: B vitamins; age; atherosclerosis; carsiovascular disease; inflammation; telomere.

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Conflict of interest statement

The authors declare no conflicts of interests.

Figures

Figure 1
Figure 1
Telomere shortening causes genomic instability, which (1) triggers cell-cycle arrest, senescence, and apoptosis of vascular smooth muscle cells, (2) reduces the regenerative capacity of blood vessel tissue, and (3) promotes the formation of a necrotic core in atherosclerotic plaques. Ultimately, this increases the risk of cardiovascular events. Telomere length could be preserved through lifestyle interventions, such as regular physical activity, low-stress levels, healthy diet, and sleeping patterns. * supported by correlation studies, + supported by functional studies in vivo or in vitro.
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