Skip to main content
SpringerLink
Log in

Alterations in Circulatory Function

  • Chapter
Book cover Geriatric Anesthesiology

Abstract

According to a 2006 statistical update published by the American Heart Association, 37.3% of all deaths in the United States in 2003 were attributable to cardiovascular disease (CVD).1 About 83% of the deaths related to CVD occur in people age 65 and older. The prevalence of CVD in American men and women aged 65–74 are 68.5% and 75%, respectively. For those aged 75+, prevalence is 77.8% and 86.4%, respectively. These numbers demonstrate the strong association between adverse cardiac events and the aging process.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics—2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2006;113:85–151.

    Article  Google Scholar 

  2. Seymour DG, Vaz FG. A prospective study of elderly general surgical patients: II. Post-operative complications. Age Ageing 1989;18:316–326.

    Article  PubMed  CAS  Google Scholar 

  3. Lakatta EG. Changes in cardiovascular function with aging. Eur Heart J 1990;11:22–29.

    PubMed  Google Scholar 

  4. Bakris GL, Bank AJ, Kass DA, et al. Advanced glycation end-product cross-link breakers. A novel approach to cardiovascular pathologies related to the aging process. Am J Hypertens 2004;17:23S–30S.

    Article  PubMed  CAS  Google Scholar 

  5. Aronson D, Rayfield EJ. How hyperglycemia promotes atherosclerosis: molecular mechanisms. Cardiovasc Diabetol 2002;1:1–10.

    Article  PubMed  Google Scholar 

  6. Yu BP, Chung HY. Oxidative stress and vascular aging. Diabetes Res Clin Pract 2001;54:S73–80.

    Article  PubMed  CAS  Google Scholar 

  7. Kass DA, Bronzwaer JGF, Paulus WJ. What mechanisms underlie diastolic dysfunction in heart failure? Circ Res 2004;94:1533–1542.

    Article  PubMed  CAS  Google Scholar 

  8. Rooke GA. Cardiovascular aging and anesthetic implications. J Cardiothorac Vasc Anesth 2003;17:512–523.

    Article  PubMed  Google Scholar 

  9. Turner MJ, Mier CM, Spina RJ, et al. Effects of age and gender on cardiovascular responses to phenylephrine. J Gerontol Med Sci 1999;54A:M17–24.

    CAS  Google Scholar 

  10. Vinch CS, Aurigemma GP, Simon HU, et al. Analysis of left ventricular systolic function using midwall mechanics in patients >60 years of age with hypertensive heart disease and heart failure. Am J Cardiol 2005;96:1299–1303.

    Article  PubMed  Google Scholar 

  11. Aronson S, Fontes ML. Hypertension: a new look at an old problem. Curr Opin Anaesthesiol 2006;19:59–64.

    Article  PubMed  Google Scholar 

  12. Mottram PM, Haluska BA, Leano R, et al. Relation of arterial stiffness to diastolic dysfunction in hypertensive heart disease. Heart 2005;91:1551–1556.

    Article  PubMed  CAS  Google Scholar 

  13. Rooke GA, Feigl EO. Work as a correlate of canine left ventricular oxygen consumption, and the problem of catecholamine oxygen wasting. Circ Res 1982;50:273–286.

    PubMed  CAS  Google Scholar 

  14. Bulpitt CJ, Rajkumar C, Cameron JD. Vascular compliance as a measure of biological age. J Am Geriatr Soc 1999;47: 657–663.

    PubMed  CAS  Google Scholar 

  15. Kass DA. Ventricular arterial stiffening—integrating the pathophysiology. Hypertension 2005;46:185–193.

    Article  PubMed  CAS  Google Scholar 

  16. Najjar SS, Scuteri A, Lakatta EG. Arterial aging—is it an immutable cardiovascular risk factor? Hypertension 2005; 46:454–462.

    Article  PubMed  CAS  Google Scholar 

  17. Ebert TJ, Morgan BJ, Barney JA, et al. Effects of aging on baroreflex regulation of sympathetic activity in humans. Am J Physiol 1992;263:H798–H803.

    PubMed  CAS  Google Scholar 

  18. Brodde O-E, Leineweber K. Autonomic receptor systems in the failing and aging human heart: similarities and differences. Eur J Pharmacol 2004;500:167–176.

    Article  PubMed  CAS  Google Scholar 

  19. Leineweber K, Wangemann T, Giessler C, et al. Agedependent changes of cardiac neuronal noradrenaline reuptake transport (uptake1) in the human heart. J Am Coll Cardiol 2002;40:1459–1465.

    Article  PubMed  CAS  Google Scholar 

  20. Hees PS, Fleg JL, Mirza ZA, et al. Effects of normal aging on left ventricular lusitropic, inotropic, and chronotropic responses to dobutamine. J Am Coll Cardiol 2006;47: 1440–1447.

    Article  PubMed  CAS  Google Scholar 

  21. Alemany R, Perona JS, Sánchez-Dominguez JM, et al. G protein-coupled receptor systems and their lipid environment in health disorders during aging. Biochim Biophys Acta 2007;1768(4):964–975.

    Article  PubMed  CAS  Google Scholar 

  22. McNamara DM, MacGowan GA, London B. Clinical importance of beta-adrenoceptor polymorphisms in cardiovascular disease. Am J Pharmacogenomics 2002;2:73–78.

    Article  PubMed  CAS  Google Scholar 

  23. Passmore JC, Rowell PP, Joshua IG, et al. Alpha 1 adrenergic receptor control of renal blood vessels during aging. Can J Physiol Pharmacol 2005;83:335–342.

    Article  PubMed  CAS  Google Scholar 

  24. Folkow B, Svanborg A. Physiology of cardiovascular aging. Physiol Rev 1993;73:725–764.

    PubMed  CAS  Google Scholar 

  25. Talke P, Stapelfeldt C, Lobo E, et al. Effect of á2badrenoceptor polymorphism on peripheral vasoconstriction in healthy volunteers. Anesthesiology 2005;102:536–542.

    Article  PubMed  CAS  Google Scholar 

  26. Mancia G, Mark AL. Arterial baroreflexes in humans. In: Shepherd JT, ed. The Cardiovascular System. Bethesda, MD: American Physiological Society; 1983:755–793.

    Google Scholar 

  27. Brodde O-E, Konschak U, Becker K, et al. Cardiac muscarinic receptors decrease with age. In vitro and in vivo studies. J Clin Invest 1998;101:471–478.

    Article  PubMed  CAS  Google Scholar 

  28. Liu HR, Zhao RR, Zhi JM, et al. Screening of serum autoantibodies to cardiac beta1-adrenoceptors and M2-muscarinic acetylcholine receptors in 408 healthy subjects of varying ages. Autoimmunity 1999;29:43–51.

    Article  PubMed  Google Scholar 

  29. Ferrari AU. Modifications of the cardiovascular system with aging. Am J Geriatr Cardiol 2002;11:30–43.

    Article  PubMed  Google Scholar 

  30. Long DA, Mu W, Price KL, et al. Blood vessels and the aging kidney. Nephron Exp Nephrol 2005;101:e95–99.

    Article  PubMed  Google Scholar 

  31. Kugler JP, Hustead T. Hyponatremia and hypernatremia in the elderly. Am Fam Physician 2000;15:3623–3630.

    Google Scholar 

  32. Podrid PJ. Atrial fibrillation in the elderly. Cardiol Clin 1999;17:173–188.

    Article  PubMed  CAS  Google Scholar 

  33. Amar D. Perioperative atrial tachyarrhythmias. Anesthesiology 2002;97:1618–1623.

    Article  PubMed  Google Scholar 

  34. Gupta AK, Maheshwari A, Tresch DD, et al. Cardiac arrhythmias in the elderly. Card Electrophysiol Rev 2002; 6:120–128.

    Article  PubMed  Google Scholar 

  35. Riess ML, Stowe DF, Warltier DC. Cardiac pharmacological preconditioning with volatile anesthetics: from bench to bedside? Am J Physiol 2004;286:H1603–1607.

    CAS  Google Scholar 

  36. Maybaum S, Ilan M, Mogilevsky J, et al. Improvement in ischemic parameters during repeated exercise testing: a possible model for myocardial preconditioning. Am J Cardiol 1996;78:1087–1091.

    PubMed  CAS  Google Scholar 

  37. Abete P, Ferrara N, Cacciatore F, et al. Angina-induced protection against myocardial infarction in adult and elderly patients: a loss of preconditioning mechanism in the aging heart? J Am Coll Cardiol 1997;30:947–954.

    Article  PubMed  CAS  Google Scholar 

  38. Longobardi G, Abete P, Ferrara N, et al. “Warm-up” phenomenon in adult and elderly patients with coronary artery disease: further evidence of the loss of “ischemic preconditioning” in the aging heart. J Gerontol 2000;55A: M124–129.

    Google Scholar 

  39. Sniecinski R, Liu H. Reduced efficacy of volatile anesthetic preconditioning with advanced age in isolated rat myocardium. Anesthesiology 2004;100:589–597.

    Article  PubMed  CAS  Google Scholar 

  40. Riess ML, Camara AK, Rhodes SS, et al. Increasing heart size and age attenuate anesthetic preconditioning in guinea pig isolated hearts. Anesth Analg 2005;101:1572–1576.

    Article  PubMed  Google Scholar 

  41. Shannon RP, Wei JY, Rosa RM, et al. The effect of age and sodium depletion on cardiovascular response to orthostasis. Hypertension 1986;8:438–443.

    PubMed  CAS  Google Scholar 

  42. Ebert TJ, Harkin CP, Muzi M. Cardiovascular responses to sevoflurane: a review. Anesth Analg 1995;81:S11–S22.

    Article  PubMed  CAS  Google Scholar 

  43. Ebert TJ, Muzi M. Propofol and autonomic reflex function in humans. Anesth Analg 1994;78:369–375.

    PubMed  CAS  Google Scholar 

  44. Burgos LG, Ebert TJ, Asiddao C, et al. Increased intraoperative cardiovascular morbidity in diabetics with autonomic neuropathy. Anesthesiology 1989;70:591–597.

    Article  PubMed  CAS  Google Scholar 

  45. Forrest JB, Rehder K, Cahalan MK, et al. Multicenter study of general anesthesia. III. Predictors of severe perioperative adverse outcomes. Anesthesiology 1992;76: 3–15.

    Article  PubMed  CAS  Google Scholar 

  46. Carpenter RL, Caplan RA, Brown DL, et al. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology 1992;76:906–916.

    Article  PubMed  CAS  Google Scholar 

  47. Filipovic M, Wang J, Michaux I, et al. Effects of halothane, sevoflurane and propofol on left ventricular diastolic function in humans during spontaneous and mechanical ventilation. Br J Anaesth 2005;94:186–192.

    Article  PubMed  CAS  Google Scholar 

  48. Rooke GA, Freund PR, Jacobson AF. Hemodynamic response and change in organ blood volume during spinal anesthesia in elderly men with cardiac disease. Anesth Analg 1997;85:99–105.

    Article  PubMed  CAS  Google Scholar 

  49. Levine WC, Mehta V, Landesberg G. Anesthesia for the elderly: selected topics. Curr Opin Anaesthesiol 2006;19: 320–324.

    Article  PubMed  Google Scholar 

  50. Stanton-Hicks M, Hock A, Stuhmeier K-D, et al. Venoconstrictor agents mobilize blood from different sources and increase intrathoracic filling during epidural anesthesia in supine humans. Anesthesiology 1987;66:317–322.

    Article  PubMed  CAS  Google Scholar 

  51. Smith JS, Roizen MF, Cahalan MK, et al. Does anesthetic technique make a difference? Augmentation of systolic blood pressure during carotid endarterectomy: effects of phenylephrine versus light anesthesia and of isoflurane versus halothane on the incidence of myocardial ischemia. Anesthesiology 1988;69:846–853.

    Article  PubMed  CAS  Google Scholar 

  52. Tiret L, Desmonts JM, Hatton F, et al. Complications associated with anaesthesia—a prospective survey in France. Can Anaesth Soc J 1986;33:336–344.

    PubMed  CAS  Google Scholar 

  53. Ebert TJ, Muzi M, Berens R, et al. Sympathetic responses to induction of anesthesia in humans with propofol or etomidate. Anesthesiology 1992;76:725–733.

    Article  PubMed  CAS  Google Scholar 

  54. Sear JW, Higham H. Issues in the perioperative management of the elderly patient with cardiovascular disease. Drugs Aging 2002;19:429–451.

    Article  PubMed  Google Scholar 

  55. Ebert TJ, Robinson BJ, Uhrich TD, et al. Recovery from sevoflurane anesthesia: a comparison to isoflurane and propofol anesthesia. Anesthesiology 1998;89:1524–1531.

    Article  PubMed  CAS  Google Scholar 

  56. Mangano DT, Layug EL, Wallace A, et al. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. N Engl J Med 1996;335:1713–1720.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA

    Thomas J. Ebert MD, PhD (Professor and Vice-Chair for Education)

  2. Department of Anesthesiology, University of Washington and the Veterans Affairs Puget Sound Health Care System, Seattle, WA

    G. Alec Rooke MD, PhD (Professor, Visiting Professor of Anesthesia, Critical Care, and Pain Medicine)

  3. Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA

    G. Alec Rooke MD, PhD (Professor, Visiting Professor of Anesthesia, Critical Care, and Pain Medicine)

Authors
  1. Thomas J. Ebert MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Alec Rooke MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Surgery, and Geriatrics and Adult Development , Mount Sinai School of Medicine, New York, NY, USA

    Jeffrey H. Silverstein MD (Professor, Vice Chairman for Research, Associate Dean for Research) (Professor, Vice Chairman for Research, Associate Dean for Research)

  2. Department of Anesthesiology, University of Washington and the Veterans Affairs Puget Sound Health Care System, Seattle, WA

    G. Alec Rooke MD, PhD (Professor and Visiting Professor of Anesthesia, Critical Care, and Pain Medicine) (Professor and Visiting Professor of Anesthesia, Critical Care, and Pain Medicine)

  3. Harvard Medical School Beth Israel Deaconess Medical Center, Boston, MA, USA

    G. Alec Rooke MD, PhD (Professor and Visiting Professor of Anesthesia, Critical Care, and Pain Medicine) (Professor and Visiting Professor of Anesthesia, Critical Care, and Pain Medicine)

  4. College of Medicine Department of Anesthesiology/College of Medicine, Medical University of South Carolina, Charleston, SC, USA

    J. G. Reves MD (Vice President for Medical Affairs, Dean) (Vice President for Medical Affairs, Dean)

  5. Salt Lake City, UT, USA

    Charles H. McLeskey MD

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Ebert, T.J., Rooke, G.A. (2008). Alterations in Circulatory Function. In: Silverstein, J.H., Rooke, G.A., Reves, J.G., McLeskey, C.H. (eds) Geriatric Anesthesiology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-72527-7_10

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-72527-7_10

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-72526-0

  • Online ISBN: 978-0-387-72527-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation