Cardiovascular aging and heart failure

Helen Oxenham1, Norman Sharpe

  • 1Department of Cardiology, Royal Infirmary of Edinburgh, Lauriston Place, Scotland, EH3 9QW, Edinburgh, UK. helen.oxenham@btopenworld.com

Insights

Aging significantly impacts the cardiovascular system, altering heart and artery function at rest and during exercise. These age-related changes can increase susceptibility to cardiac diseases in older adults.

Area of Science:

  • Cardiovascular physiology
  • Gerontology
  • Exercise physiology

Background:

  • Aging is a primary driver of cardiovascular system alterations in older individuals.
  • Arterial stiffening affects cardiac afterload and left ventricular geometry.
  • While resting systolic function is preserved, diastolic function declines substantially with age.

Purpose of the Study:

  • To review age-related changes in cardiovascular structure and function.
  • To describe alterations at rest and during exercise in older populations.
  • To highlight the consequences of these cardiovascular changes.

Main Methods:

  • This is a review article, synthesizing existing research.
  • It focuses on structural and functional cardiovascular changes in aging.
  • The review examines effects on both resting and exercise conditions.

Main Results:

  • Aging leads to arterial stiffening and altered left ventricular geometry.
  • Left ventricular diastolic function is significantly impaired in older adults.
  • Cardiovascular responses to exercise are substantially modified by aging.

Conclusions:

  • Age-related cardiovascular changes affect heart and vascular function.
  • These changes can lower the threshold for cardiac disease manifestation.
  • Exercise training or genetic modification can potentially mitigate some age-related cardiovascular declines.

Related Concept Videos

Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...