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Modifications of the cardiovascular system with aging
1Cardioriabilitazione, Ospedale di Seregno, Az Osp Vimercate (MI), Centro di Fisiologia Clinica e Ipertensione, Universita di Milano-Bicocca, Via F. Sforza, 35, 20122 Milan, Italy. alberto.ferrari@unimib.it
Insights
Cardiovascular system changes with aging, including structural and functional modifications. Older adults experience altered blood pressure regulation and reduced heart rate variability, impacting overall cardiovascular homeostasis.
Area of Science:
- Cardiovascular Physiology
- Gerontology
- Neuroendocrinology
Background:
- Aging induces significant structural and functional cardiovascular changes.
- Key cardiovascular parameters like heart rate and arterial distensibility are altered with age.
Purpose of the Study:
- To comprehensively review the cardiovascular modifications associated with aging.
- To elucidate the impact of aging on cardiovascular homeostasis and regulatory systems.
Main Methods:
- Review of existing literature on cardiovascular aging.
- Analysis of structural, functional, and neurohumoral changes in the aging cardiovascular system.
Main Results:
- Aging leads to left ventricular hypertrophy, decreased heart rate, and reduced arterial distensibility.
- Sympathetic nervous system activity is increased, while renin-angiotensin system activity is blunted.
- Elderly individuals exhibit increased blood pressure variability and impaired reflex responses.
Conclusions:
- Aging significantly alters cardiovascular structure, function, and neurohumoral regulation.
- These changes result in altered cardiovascular homeostasis and a propensity for hypotension in the elderly.
- Impaired reflex responses contribute to the cardiovascular challenges faced by aging populations.
Abstract:
Aging is accompanied by significant cardiovascular modifications, both structural and functional. A slight degree of left ventricular hypertrophy develops, while the resting heart rate and early filling rate are somewhat decreased. In contrast, end-diastolic and end-systolic dimensions, stroke volume, and ejection fraction are largely unchanged. The effort tachycardic and inotropic responses are clearly attenuated, whereas the concomitant increase in end-diastolic diameter is enhanced. Large arterial conduits become less distensible and somewhat hypertrophic. Total blood volume is reduced, whereas total peripheral resistance is moderately increased. Neurohumoral systems relevant to cardiovascular regulation are nonuniformly affected by aging: the sympathetic nervous system is overactive and the circulating levels of vasopressin and atrial natriuretic factor are enhanced, while the activity of the renin-angiotensin system is blunted. Elderly individuals have altered cardiovascular homeostasis, with a typical propensity to postural and postprandial hypotension. "Spontaneous" blood pressure variability is increased, whereas heart rate variability is diminished. Vagally mediated chronotropic responses, including those dependent on baroreflex modulation, are attenuated, although end-organ (cardiac) parasympathetic responsiveness is exaggerated. Arterial baroreceptor control of blood pressure is largely preserved in advanced age, whereas cardiopulmonary-mediated reflex responses are definitely impaired.