Physiological changes due to age. Implications for cardiovascular drug therapy

Area of Science:

• Gerontology
• Cardiovascular Physiology
• Clinical Pharmacology

Background:

• Cardiovascular disease is a leading cause of mortality in the elderly population.
• Existing research on aging cardiovascular physiology and pharmacology often suffers from methodological limitations.
• Common issues include unmeasured drug bioavailability and subject selection bias (overt or subclinical disease).

Purpose of the Study:

• To critically evaluate the existing literature on the aging cardiovascular system.
• To identify age-related physiological changes affecting cardiovascular function.
• To assess the implications of aging on drug disposition and elimination.

Main Methods:

• Review and analysis of published studies on cardiovascular aging.
• Examination of physiological parameters such as heart rate, cardiac output, and baroreceptor reflex.
• Investigation of neurochemical changes, including plasma noradrenaline levels and adrenoceptor sensitivity.

Main Results:

• Maximum heart rate decreases with age, showing an inverse relationship with exercise-induced heart rate rise.
• Baroreceptor reflex activity declines with advancing age.
• Cardiac output is maintained in older adults through a slower heart rate and increased stroke volume.
• Plasma noradrenaline levels rise in the elderly, while alpha 1-adrenoceptor sensitivity remains unchanged.
• Evidence suggests a decline in beta 2-adrenoceptor activity with age.

Conclusions:

• Generalizing the effects of aging on drug disposition and elimination is challenging.
• Each drug's pharmacokinetic profile in the elderly requires individual assessment.
• Understanding age-related cardiovascular changes is crucial for optimizing geriatric pharmacotherapy.