A new study published in the European Heart Journal investigated the extent to which the manifestations of vascular ageing – arterial stiffening, dilation, and arterial wall thickening, are related and their heritability, during a five-year follow-up in the Twins UK cohort. This study entailed measurements of carotid-femoral pulse wave velocity (PWVcf), carotid diameter, carotid distensibility, and carotid intima-media thickness (IMT) in 762 female twins of mean age 57.9 ± 8.6 years at two time-points over an average follow-up period of 4.9 ± 1.5 years. Magnetic resonance imaging (MRI) was performed in a sub-sample of 38 women to measure aortic pulse wave velocity (PWV aorta), diameter, and wall thickness. Heritability of changes in arterial wall properties was estimated using structural equation modelling. The findings revealed that the annual increases in PWVcf, carotid diameter, distensibility, and IMT were 0.139 m/s, 0.028 mm, -0.4 kPa-1, and 0.011 mm per year, respectively. The predictors of progression in PWVcf included age, mean arterial pressure (MAP), and heart rate (HR) at baseline, and progression in MAP, HR, and body mass index (BMI). While predictors of progression in IMT included progression in MAP, BMI, and triglyceride levels. On the other hand, progression of PWV and distensibility correlated with progression in carotid diameter, but not with IMT. Additionally, heritability of progression of PWVcf, diameter, and IMT were 55%, 21%, and 8%, respectively. Furthermore, in a sub-sample of women that underwent MRI, aortic wall thickness increased by 0.19 mm/year, but aortic wall thickening was not correlated with an increase in lumen diameter or PWV aorta. The results suggested that arterial stiffening, as measured by PWVcf, and dilation are heritable but independent of arterial wall thickening. It was stated that genetic and cardiovascular risk factors contribute differently to progression of PWV and IMT.