title: Telomere length dynamics in vascular disease: a review.
abstract: BACKGROUND
  Telomeres are specialised DNA-protein complexes which cap the ends of linear chromosomes serving to maintain DNA integrity during cell division. Telomere length naturally shortens with successive cell divisions and represents a cellular marker of biological age. This paper aims to provide an overview of telomere biology and review the evidence for any association between vascular surgical conditions and short telomere length.
  
  
  METHODS
  A systematic review of the literature was performed using the search terms 'telomere' and 'vascular'.
  
  
  RESULTS
  Considerable associations between a shorter mean telomere length and coronary heart disease have been observed. This finding extends to vascular disease risk factors including age, sex, smoking, obesity, hypertension and diabetes. Vascular diseases including abdominal aortic aneurysm, peripheral vascular disease and carotid disease were also associated with shorter telomere lengths but evidence was limited to a small number of studies. There were no reports of short telomere length associated with varicose veins or arterio-venous malformations suggesting a novel area for further investigation.
  
  
  CONCLUSIONS
  Multiple associations between short telomere length and vascular disease characterised by atherosclerosis suggest a possible link between telomere attrition and disease mechanisms. Further studies are warranted to validate and define the role of telomeres in vascular disease pathogenesis.
authors.affiliation: Vascular Surgery Group, Department of Cardiovascular Sciences, University of Leicester, Leicester LE2 7LX, United Kingdom. hzbutt@doctors.org.uk
authors.forename: H Z
authors.initials: HZ
authors.lastname: Butt
authors.forename: G
authors.initials: G
authors.lastname: Atturu
authors.forename: N J
authors.initials: NJ
authors.lastname: London
authors.forename: R D
authors.initials: RD
authors.lastname: Sayers
authors.forename: M J
authors.initials: MJ
authors.lastname: Bown
mesh_terms: D019317:Evidence-Based Medicine; D020022:Genetic Predisposition to Disease; D006801:Humans; D010641:Phenotype; D018570:Risk Assessment; D012307:Risk Factors; D016615:Telomere / Q000378:metabolism*; D014652:Vascular Diseases / Q000235:genetics* / Q000473:pathology