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Updated: Jun 28, 2025

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Aging in Heart Failure: Embracing Biology Over Chronology: JACC Family Series

Parag Goyal1, Mathew S Maurer2, Jason Roh3

  • 1Department of Medicine, Weill Cornell Medicine, New York, New York, USA.

JACC. Heart Failure
|April 10, 2024
PubMed

Insights

Aging significantly impacts heart failure development and outcomes. This review explores biological aging mechanisms and therapeutic targets for heart failure in older adults, emphasizing geriatric care.

Area of Science:

  • Cardiology
  • Gerontology
  • Molecular Biology

Background:

  • Age is a primary risk factor for heart failure (HF) and adverse outcomes.
  • The global population is aging, increasing HF prevalence and the need to understand aging's role.
  • Biological aging, unlike chronological age, is variable and potentially modifiable in HF patients.

Purpose of the Study:

  • To review current knowledge on biological aging mechanisms contributing to heart failure pathogenesis.
  • To highlight key hallmarks of aging targeted in current therapeutic development for older adults with HF.
  • To emphasize the importance of geriatric conditions in HF management and clinical trials.

Main Methods:

  • Literature review focusing on biological aging mechanisms in heart failure.
  • Analysis of three hallmarks of aging: impaired proteostasis, mitochondrial dysfunction, and deregulated nutrient sensing.
  • Assessment of existing and emerging therapeutic strategies for older adults with HF.

Main Results:

  • Impaired proteostasis, mitochondrial dysfunction, and deregulated nutrient sensing are key aging mechanisms in HF.
  • These hallmarks are targets for novel therapeutic interventions in older adults with HF.
  • Geriatric conditions are crucial considerations for HF management and clinical trial design.

Conclusions:

  • Understanding biological aging is essential for addressing the rising prevalence of heart failure in older populations.
  • Targeting hallmarks of aging offers promising therapeutic avenues for heart failure.
  • Integrating geriatric principles into HF care and research is vital for improving outcomes in older adults.

Keywords:
aging biologygeriatricsheart failure

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