Emergent cardiovascular risk factors in the very elderly

An appreciable amount of evidence generated in the recent decades has changed the incidence and mortality of cardiovascular diseases dramatically. This advance has resulted in increased survival and, consequently, in a large new generation of very elderly individuals. In parallel, the aging of the population brought out a puzzle and a challenge for the next millennium. Despite the role of selective survival in attenuating the expression and impact of traditional risk factors, today's elderly still has a gradual increase in unstable plaque formation and, by this way, the incidence of acute cardiovascular events. Recent studies have indicated aging-related emergence of new potential modulators of atherogenesis such as cellular senescence, immunosenescence, the syndrome of frailty, sarcopenia and sirtuins. This review will focus on the most recent and relevant evidence regarding the impact of these new players on atherogenicity in the elderly.