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Updated: Jun 23, 2025

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Published on: June 14, 2020
Cardiac ageing: from hallmarks to therapeutic opportunities
Margaret H Hastings1, Qiulian Zhou1, Chao Wu1
1Stanley and Judith Frankel Institute for Heart and Brain Health, University of Michigan Medical Center, Department of Internal Medicine, North Campus Research Complex, 2800 Plymouth Rd, NCRC Building 25, Ann Arbor, MI 48109-2800, USA.
Insights
Cardiac aging involves structural and functional changes, impacting heart health, especially in older adults. Exercise shows promise in mitigating these effects and improving cardiac function.
Area of Science:
- Cardiology
- Gerontology
- Molecular Biology
Background:
- Cardiac aging is a complex process with significant public health implications due to global aging populations.
- Heart failure with preserved ejection fraction (HFpEF) is a growing concern in aging individuals.
- Understanding the molecular basis of cardiac aging is crucial for developing effective interventions.
Purpose of the Study:
- To review the structural, cellular, and functional changes in the aging heart.
- To explore molecular mediators of cardiac aging within the context of aging hallmarks.
- To discuss the differential effects of aging on cardiac health in men and women, and the role of exercise.
Main Methods:
- Literature review of structural, cellular, and functional changes in cardiac aging.
- Analysis of molecular mediators and their relation to aging hallmarks.
- Examination of sex-specific differences and the impact of exercise on cardiac aging and HFpEF.
Main Results:
- Cardiac aging involves multifaceted changes affecting structure, cellular processes, and function.
- Key molecular mediators are linked to established hallmarks of aging, with potential therapeutic targets identified.
- Significant differences exist in cardiac aging between sexes, influenced by hormones and chromosomes; exercise demonstrates protective effects.
Conclusions:
- Cardiac aging is a complex process requiring further research to enhance cardiac health in aging populations.
- Identifying pathways that mitigate biological aging is essential for preventing and treating age-related cardiac conditions like HFpEF.
- Therapeutic strategies targeting molecular mediators and leveraging lifestyle interventions like exercise are promising for improving cardiovascular outcomes in the elderly.
Abstract:
Cardiac ageing is an intricate and multifaceted process with considerable impact on public health, especially given the global demographic shift towards aged populations. This review discusses structural, cellular, and functional changes associated with cardiac ageing and heart failure with preserved ejection fraction (HFpEF). Key molecular mediators are considered within the framework of the established hallmarks of ageing, with particular attention to promising therapeutic candidates. We further delineate the differential impacts of ageing on cardiac structure and function in men and women, addressing hormonal and chromosomal influences. The protective and mitigating effects of exercise in cardiac ageing and HFpEF in particular are discussed, as an inspiration for the identification of pathways that mitigate biological ageing. We also emphasize how much remains to be learned and the importance of these efforts in enhancing the cardiac health of ageing populations worldwide.
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