Abstract Body (Do not enter title and authors here): Introduction:
Healthy Vascular Aging (HVA) refers to the preservation of vascular function with advancing age, challenging the common belief that hypertension and increased arterial stiffness are unavoidable outcomes of aging (Hypertension, PMID: 28559398). This definition identifies individuals who retain young vascular characteristics beyond midlife. While traditional clinical metrics are used to assess HVA, waveform-derived biomarkers, such as cardiovascular intrinsic frequencies (IFs), may provide a non-invasive and physiologically grounded alternative. IFs extracted from carotid pressure waveforms have previously been shown to be associated with cardiovascular function and vascular health (Hypertension, PMID: 33390053). In this study, we examine the association between carotid-derived IFs and the HVA status.

Methods:
The study sample was drawn from the Original (Exam 26), Offspring (Exam 7), and Third Generation (Exam 1) cohorts of the Framingham Heart Study. As established in the literature, we assigned HVA to the individuals with age ≥ 50 years, systolic blood pressure <140 mmHg, diastolic blood pressure <90 mmHg (without hypertension medication), and a carotid-femoral pulse wave velocity <7.6 m/s. After applying these criteria, a total of N = 2,242 participants remained for analysis. Carotid pressure waveforms were acquired using applanation tonometry. We used these waveforms and computed the IF metrics for each individual: ω_1c (IF during systole, related to left ventricular inotropic function and LV-arterial coupling) and ω_2c (IF during diastole, related to arterial function). The associations between the HVA status and carotid-derived IFs were assessed using box-and-whisker plots and the Mann–Whitney U test.
Results:
The carotid-based IF metrics showed statistically significant differences between individuals with and without HVA (p < 0.0001 for all comparisons). The group-wise distributions of these parameters are illustrated in Figure 1, highlighting distinct shifts in IF values between the HVA and no-HVA groups. Lower ω_1c but higher ω_2c were observed in the HVA group.
Conclusion:
Our results demonstrated that Intrinsic frequencies of carotid pressure waveforms are associated with the status of vascular aging. The findings of this study support the potential utility of IFs as a non-invasive approach to assess vascular health aging.