Vascular endothelial cell (EC) aging has a strong impact on tissue perfusion and overall cardiovascular health. While studies confined to the investigation of aging-associated vascular readouts in one or a few tissues have already drastically expanded our understanding of EC aging, single-cell omics and other high-resolution profiling technologies have started to illuminate the intricate molecular changes underlying endothelial aging across diverse tissues and vascular beds at scale. In this review, we provide an overview of recent insights into the heterogeneous adaptations of the aging vascular endothelium. We address critical questions regarding tissue-specific and universal responses of the endothelium to the aging process, EC turnover dynamics throughout lifespan, and the differential susceptibility of ECs to acquiring aging-associated traits. In doing so, we underscore the transformative potential of single-cell approaches in advancing our comprehension of endothelial aging, essential to foster the development of future innovative therapeutic strategies for aging-associated vascular conditions.

血管内皮细胞（EC）老化对组织灌注和整体心血管健康有很大影响。虽然仅限于研究一种或几种组织中与衰老相关的血管读数的研究已经极大地扩展了我们对 EC 衰老的理解，但单细胞组学和其他高分辨率分析技术已经开始阐明内皮衰老背后的复杂分子变化大规模跨越不同的组织和血管床。在这篇综述中，我们概述了对衰老血管内皮异质适应的最新见解。我们解决了有关内皮细胞对衰老过程的组织特异性和普遍反应、整个生命周期内皮细胞更新动态以及内皮细胞对获得衰老相关特征的不同敏感性的关键问题。在此过程中，我们强调单细胞方法在促进我们对内皮衰老的理解方面的变革潜力，这对于促进与衰老相关的血管疾病的未来创新治疗策略的发展至关重要。