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Ao Li,1,2 Jinhua Yan,3 Ya Zhao,2 Zhenping Yu,4 Shane Tian,5 Abdul Haseeb Khan,2 Yuanzheng Zhu,2 Andong Wu,2 Cuntai Zhang,3 Xiao-Li Tian2 1Queen Mary School, Nanchang University, Nanchang, Jiangxi, 330031, People’s Republic of China; 2Aging and Vascular Diseases, Human Aging Research Institute (HARI) and School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China; 3Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 4Institute of Translational Medicine, School of Life Science, Nanchang University, and Jiangxi Key Laboratory of Human Aging, Nanchang, Jiangxi, 330031, People’s Republic of China; 5Department of Biochemistry/Chemistry, Ohio State University, Columbus, OH, USACorrespondence: Xiao-Li Tian; Cuntai Zhang, Email tianxiaoli@ncu.edu.cn; ctzhang@tjh.tjmu.edu.cnAbstract: Vascular aging represents a collection of structural and functional changes in a blood vessel with advancing age, including increased stiffness, vascular wall remodeling, loss of angiogenic ability, and endothelium-dependent vasodilation dysfunction. These age-related alterations may occur earlier in those who are at risk for or have cardiovascular diseases, therefore, are defined as early or premature vascular aging. Vascular aging contributes independently to cardio-cerebral vascular diseases (CCVDs). Thus, early diagnosis and interventions targeting vascular aging are of paramount importance in the delay or prevention of CCVDs. Here, we review the direct assessment of vascular aging by examining parameters that reflect changes in structure, function, or their compliance with age including arterial wall thickness and lumen diameter, endothelium-dependent vasodilation, arterial stiffness as well as indirect assessment through pathological studies of biomarkers including endothelial prog