HTN and Aging of the Heart

=Objectives= The objectives were answered in a very consolidated direct fashion in the study guide in about one page of easy memorizing, which cannot be shortened effectively.

1. Understand the normal changes of the vessels, valves, myocardium, and conduction system associated with aging.

2. Differentiate the effects of disease processes from those of “aging”.

3. Understand the physiologic effects on rest and exercise of the aging process.


 * Nearly everyone has some cardiovascular
 * There are common mechanisms for aging and for disease.
 * Many of the physiologic effects of aging and disease are the same.
 * The aging process provides fertile ground for atherosclerosis

Age-Associated Changes in Central Arterial Structure and Function During Normative Aging:

 * Increases: intimal-medial thickness, collagen content, lumen size, stiffness, systolic pressure and pulse pressure
 * Decreases: elastin (frayed) and endothelial function

Valvular Heart Disease

 * Aging of the valves does not produce clinical disease
 * Numerous conditions (rheumatic, degenerative, infectious) produce either stenosis or insufficiency of the valves

Conduction System

 * There is a progressive loss of cells in the SA node that leads to dysfunction in a small number
 * Progressive fibrosis of the specialized conduction tissue leads to delay blockages in some
 * A variety of cardiac diseases produce dysfunction of the conduction tissue

Myocardium

 * Changes in the myocardium occur due to changes in the vessels and the work of the heart with advancing age
 * The most significant myocardial dysfunction occurs as a result of identifiable diseases such as infarction, overload or inflammation.
 * The inotropic response to exercise decreases with age
 * The maximum achievable heart rate also decreases with age.

And Now What???

 * Lifestyle changes
 * Exercise
 * Weight loss
 * NaCl restriction
 * Diet
 * Drugs
 * Statins
 * ACEI, ARB