Abstract
Vascular aging, characterized by arterial thickening, reduced elasticity, and endothelial dysfunction, significantly compromises vascular health and accelerates the progression of cardiovascular diseases (CVDs). Emerging research highlights the gut-vascular axis as a critical mediator of vascular health, with the gut microbiota (GM) playing a pivotal role in modulating vascular aging and CVDs. This review presents a thorough and up-to-date discussion of the fundamental mechanisms driving vascular aging and explores how GM and its metabolites influence these processes. Furthermore, we place particular emphasis on therapeutic strategies, including probiotics and food-derived natural products, that foster beneficial bacterial growth and support cardiovascular health, while also exploring the underlying mechanisms. By targeting GM composition and function, these approaches offer promising strategies to mitigate vascular aging and lower CVD risk. Future studies aimed at deepening our understanding of the interplay between GM, its metabolites, and vascular health could pave the way for novel preventive and therapeutic interventions against vascular aging and CVDs.