# Vascular calcification

Vascular calcification is the buildup of calcium-phosphate mineral (hydroxyapatite) in your artery walls. It is an active, cell-controlled process. It is not the passive 'hardening' once assumed. There are two distinct forms. Intimal calcification forms inside atherosclerotic plaques. It is driven by inflammation, macrophages, and dying smooth-muscle cells. Medial calcification (Mönckeberg sclerosis) forms in the middle artery layer. It is independent of cholesterol, and tied to aging, diabetes, and kidney disease. In both forms, your vascular smooth-muscle cells switch toward a bone-making identity. They turn on BMP-2, BMP-4, and Runx2 while losing their contractile job (Durham et al. 2018). A built-in brake exists: Matrix Gla Protein (MGP), a vitamin K-dependent inhibitor. MGP needs vitamin K to switch on. Too little vitamin K2 leaves an inactive form (dp-ucMGP). That inactive form is a blood marker that tracks calcification and heart risk (Barrett et al. 2018). Medial calcification stiffens arteries, raises pulse-wave velocity, and adds to the heart's workload. That makes it an independent predictor of cardiovascular death in older adults. But treatment evidence is still limited.

## Sources

- Durham AL, Speer MY, Scatena M, Giachelli CM, Shanahan CM. (2018). Role of smooth muscle cells in vascular calcification: implications in atherosclerosis and arterial stiffness. Cardiovascular Research. https://doi.org/10.1093/cvr/cvy010
- Barrett H, O'Keeffe M, Kavanagh E, Walsh M, O'Connor E. (2018). Is Matrix Gla Protein Associated with Vascular Calcification? A Systematic Review. Nutrients. https://doi.org/10.3390/nu10040415
- Adelnia H, Ray S, Ta HT. (2026). Decoding vascular calcification: mechanistic insights and translational strategies. Cellular and Molecular Life Sciences. https://doi.org/10.1007/s00018-026-06086-4

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_Canonical: https://longevity-switzerland.com/en/glossary/vascular-calcification · Part of Longevity Cities · Updated 2026-06-22_