The aging diver: endothelial biochemistry and its potential implications for cardiovascular health

Divers are exposed to circulatory stress that directly affects the endothelial lining of blood vessels, and even asymptomatic dives are associated with inflammatory responses, microparticle release and endothelial dysfunction. As humans age, there is a relative increase in the risk of cardiovascular disease, attributed in part to declining endothelial function. Whether extensive diving in the older diver increases the risk of disease as a result of accumulated circulatory stress or provides protection through processes of acclimatization remains an open question. We provide a brief review of current knowledge about the separate effects of diving and aging on the vascular endothelium in humans and rodents, and discuss the available data on their combined effects. The aim is to elucidate possible outcomes of the interplay between exogenous and endogenous stress factors for endothelial function and to question potential implications for cardiovascular health in the aging diver.