Age Associated Changes In Cardiovascular Function
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Contents |
Introduction
- Cardiovascular function declines with age
- decreased inotropic & chronotropic responses
- diminished response to orthostasis
- decreased baroreceptor sensitivity
- diminished beta- adrenergic responsiveness
- stress-induced increase in LV ejection fraction & cardiac index is blunted, but responsive to training
- increased afterload resulting from
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- elongation & tortuosity of arteries, including aorta
- increased intimal thickening of arteries
- increased fibrosis of media of arteries
- fragmentation of elastin in media
- subendothelial layer thickened with connective tissue
- increased arterial stiffness
- irregularities in endothelial cells
- increased peripheral vascular resistance
- peripheral vasculature constriction is maintained
- diminished peripheral vasculature relaxation
- impaired beta-adenergic mediated vasorelaxation
- vasorelaxation to other vasodilators may be intact
- increased systolic blood pressure
- increased afterload results in LV diastolic dysfunction
- increased LV mass
- decreased mycocardial relaxation & compliance
- diminished early diastolic filling
- increased late diastolic filling
- end diastolic volume is decreased
- left atrial hypertrophy
- diastolic blood pressure tends to peak in midlife
- increased contraction duration
- decreased maximum heart rate
- refractory to training
- unchanged resting heart rate
- impaired responsiveness to beta- adrenergic stimulation
- decreased heart rate variability
- decreased maximum cardiac output
- decreased VO2 max, responsive to training
- decreased intrinsic sinus ( SA node) rate
- increased refractoriness to electrical stimulation
- decreased beta- adrenergic-mediated vasodilation
- alpha- adrenergic-mediated vasocontriction unchanged
- brain autoregulation of perfusion impaired
- decreased baroreceptor responsiveness
- sclerosis & calcification of heart valves
- increased fibrosis of myocardium
- increased fibrosis of cardiac conduction system
- increased serum ANP
More General Terms
Additional Terms
References
- Essentials of Clinical Geriatrics, 4th ed, Kane RL et al (eds) McGraw Hill, NY, 1999
- UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
- The Merck Manual of Geriatrics, 3rdh ed, Merck & Co, Rahway NJ, 2000
- Taffet GE, Physiology of Aging, In: Geriatric Medicine: An Evidence-Based Approach, 4th ed, Cassel CK et al (eds), Springer-Verlag, New York, 2003
- Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
