Vascular aging is described as a gradual process involving biochemical, enzymatic, and cellular changes of the vasculature and modification of the signals that modulate them. On the basis of this conception a new pathophysiological model for deeper understanding of cardiovascular risk and its treatment was introduced. The idea of early vascular aging, that is the acceleration of vascular aging seems to be a promising tool for clinical guidance in individuals at increased cardiovascular risk or a strong family history of early cardiovascular manifestations. Increased arterial stiffness, dilation of central elastic arteries, impaired endothelial function and vasodilatation are dominant aspects of this premature process.