Related Experiment Video
Updated: Feb 19, 2026
Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
The ageing heart: the systemic and coronary circulation
Shane Nanayakkara1,2,3, Thomas H Marwick2,4, David M Kaye1,2,3
1Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Insights
Older adults over 60 experience more cardiovascular disease (CVD), but clinical trials often exclude them. Frailty assessment is crucial for effective CVD treatment in this population.
Area of Science:
- Gerontology
- Cardiology
- Clinical Medicine
Background:
- Cardiovascular disease (CVD) predominantly affects individuals over 60.
- Current cardiovascular guidelines have limited evidence for older populations due to trial underrepresentation.
- Aging is associated with increased arterial stiffness, rising blood pressure, and myocardial ischemia, yet older patients receive less guideline-based therapy.
Purpose of the Study:
- To review cardiovascular changes associated with aging.
- To emphasize the role of frailty in the evaluation and treatment of CVD in older adults.
- To highlight the implications of arterial stiffness and myocardial changes in aging cardiovascular systems.
Main Methods:
- Literature appraisal of cardiovascular changes with aging.
- Focus on systemic and coronary circulation.
- Emphasis on frailty assessment and its impact on CVD treatment.
Main Results:
- Older adults face higher risks for CVD, but are undertreated.
- Frailty, indicated by slow gait speed, predicts mortality and adverse outcomes.
- Non-frail older individuals benefit significantly from CVD therapies.
Conclusions:
- There is an urgent need to include frailty assessment in clinical trials for CVD treatments in older adults.
- Aging impacts cardiovascular function, necessitating tailored treatment approaches.
- Optimizing CVD management in older adults requires addressing age-related changes and frailty.
Abstract:
Most cardiovascular disease (CVD) occurs in patients over the age of 60. However, most evidence-based current cardiovascular guidelines lack evidence in an older population, due to the under-representation of older patients in randomised trials. Blood pressure rises with age due to increasing arterial stiffness, and stricter control results in improved outcomes. Myocardial ischaemia is also more common with increasing age, due to a combination of coronary artery disease and myocardial changes. However, despite higher rates of adverse outcomes, older patients are offered guideline-based therapy less frequently. Frailty is an independent predictor of mortality in adults over the age of 60, yet remains poorly assessed; slow gait speed is a key marker for the development of frailty and for adverse outcomes following intervention. Few trials have assessed frailty independent of age; however, there is evidence that non-frail older patients derive significant benefit from therapy, highlighting the urgent need to include frailty as a measure in clinical trials of treatment in CVD.In this review, the authors appraise the literature in regard to the cardiovascular changes with ageing, specifically in relation to the systemic and coronary circulation and with a particular emphasis on frailty and its implication in the evaluation and treatment of CVD.
More Related Videos
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:29Heart Failure II: Pathophysiology
01:11Overview of Systemic Arteries
Systemic circulation is the part of the cardiovascular system that carries oxygenated blood away from the heart to the body's tissues and returns deoxygenated blood back to the...
01:26Imbalances in Cardiac Output
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...
01:26Coronary Artery Disease II: Pathophysiology
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...