Abstract
In Western societies both the prevalence and incidence of cardiovascular disease increase dramatically with advancing age; nevertheless, aging and disease are not synonymous. Therefore, when studying the aging process in man, one must exclude those changes in the elderly groups that in reality are due to the presence or development of disease. This chapter will attempt to delineate those changes in the heart and peripheral vasculature at rest and during exercise which are thought to represent “normal” aging. While these changes in and of themselves usually cause no disability, they provide an altered substrate on which the specific cardiovascular diseases to be discussed in subsequent chapters are superimposed. The signs, symptoms, and clinical course of these pathologic processes may be modified significantly by the physiological aging of the cardiovascular system.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Elveback L and Lie JT. Continued high prevalence of coronary artery disease at autopsy in Olmstead County, Minnesota, 1950 to 1970. Circulation 70:345–349, 1984.
White NK, Edwards JE, and Dry TJ. The relationship of the degree of coronary atherosclerosis with age. Circulation 1:645–654, 1950.
Ackerman RF, Dry TJ, and Edwards JE. Relationship of various factors to the degree of coronary atherosclerosis in women. Circulation 1:1345–1354, 1950.
Kennedy RD, Andrevor GR, and Caird FI. Ischemic heart disease in the elderly. Br Heart J 39:1121–1127, 1977.
Gerstenblith G, Fleg JL, Vantosh A, et al. Stress testing redefines the prevalence of coronary artery disease,in epidemiologic studies (abstract). Circulation 62:Part II, III-308, 1980.
Linzbach AJ and Kuamoa-Boateng E. Die Alternsveranderungen des menschlichen Herzens I. Das Herzgewicht im Alter. Klinische Wochenschrift 51:156–163, 1973.
Sjogren Al. Left ventricular wall thickness in patients with circulatory overload of the left ventricle. Ann Clin Res 4:310–318, 1972.
Gerstenblith G, Frederiksen J, Yin FCP, et al. Echocardiography assessment of a normal adult aging population. Circulation 56:273–278, 1977.
Gardin JM, Henry WL, Savage DD, et al. Echocardiographic measurements in normal subjects: Evaluation of an adult population without clinically apparent heart disease. J Clin Ultrasound 7:349–447, 1979.
Fleg JL. How does aging affect the heart? Structural and ECG changes. Drug Therapy 15:37–51, 1985.
Simonson E. The effect of age on the electrocardiogram. Am J Cardiol 29:64–73, 1972.
Das DN, Fleg JL, and Lakatta EG. Effect of age on the components of atrioventricular conduction in normal man (abstract). Am J Cardiol 49(Suppl 2): 1031, 1982.
Fleg JL and Kennedy HL. Cardiac arrhythmias in a healthy elderly population. Detection by 24-hour ambulatory electrocardiography. Chest 81:302–307, 1982.
Kantelip JP, Sage E, and Duchene-Marullaz P. Findings on ambulatory electrocardiographic monitoring in subjects older than 80 years. Am J Cardiol 57:398–401, 1986.
Ensor RE, Fleg JL, Kim YC, de Leon EF, and Goldman SM. Longitudinal chest x-ray changes in normal men. J Gerontol 38:307–314, 1983.
Avolio AP, Fa-Quan D, Wei-Qiang L, et al. Effects of aging on arterial distensibility in populations with high and low prevalence of hypertension, comparison between urban and rural communities. Circulation 71:202–210, 1985.
Brandfonbrener M, Landowne M, and Shock NW. Changes in cardiac output with age. Circulation 12:557–566, 1953.
Rodeheffer RJ, Gerstenblith G, Becker LC, et al. Exercise cardiac output is maintained with advancing age in healthy human subjects: Cardiac dilatation and increased stroke volume compensate for a diminished heart rate. Circulation 69:203–213, 1984.
Van Tosh A, Lakatta EG, Fleg JL, et al. Ventricular dimension changes during submaximal exercise. Effect of aging on normal man (abstract). Circulation 62:Part II, III–308, 1980.
Julius S, Amery A, Whitlock LS, and Conway J. Influence of age on the hemodynamic response to exercise. Circulation 36:222–230, 1967.
Miyatake K, Okamoto J, Kimoshita N, et al. Augmentation of atrial contribution to left ventricular flow with aging as assessed by intracardiac Doppler flowmetry. Am J Cardiol 53:587–589, 1984.
Froehhch JP, Lakatta EG, Beard E, et al. Studies of sarcoplasmic reticulum function and contraction duration in young and aged rat myocardium. J Mol Cell Cardiol 10:427–438, 1978.
Wei JY, Spurgeon HA, and Lakatta EG. Excitation-contraction in rat myocardium: Alterations with adult aging. Am J Physiol 246 (Heart Circ Physiol 15):H784—H791, 1984.
Orchard CH and Lakatta EG. Intracellular calcium transients and developed tensions in rat heart muscle. A mechanism for the negative interval-strength relationship. J Gen Physiol 86:637–651, 1985.
Bhatnagar GM, Effron MB, Ruano-Arroyo G, et al. Dissociation of myosin Ca2+-ATPase activity from myosin isoenzymes and contractile function in rat myocardium. Fed Proc 44:826, 1985.
Dehn MM and Bruce A. Longitudinal variations in maximal oxygen uptake with age and activity. J Appl Physiol 33:805–807, 1972.
Fleg JL and Lakatta EG. Loss of muscle mass is a major determinant of the age-related decline in maximal aerobic capacity. Circulation 72:Part II, III–464, 1985.
Robinson S, Dill DB, Ross JC, et al. Training and physiological aging in man. Fed Pro 32:1628–1634, 1973.
Heath GW, Hagberg JM, Ehsani AA, and Holloszy JO. A physiological comparison of young and older endurance athletes. J Appl Physiol 51:634–640, 1981.
Granath A, Jonsson B, and Strandell T. Circulation in healthy old men studied by right heart catheterization at rest and during exercise in suppine and sitting position. Acta Med Scand 176:425–446, 1964.
Conway J, Wheeler R, and Hammerstedt R. Sympathetic nervous activity during exercise in relation to age. Cardiovasc Res 5:577–581, 1977.
Port S, Cobb FR, Coleman RE, and Jones RH. Effect of age on the response of the left ventricular ejection fraction to exercise. N Engl J Med 303:1133–1137, 1980.
Yin FCP, Weisfeldt ML, and Milnor WR. Role of aortic input impedance in the decreased cardiovascular response to exercise with aging in ddogs. J Clin Invest 68:28–38, 1981.
Lakatta EG, Gerstenblith G, Angell CS, et al. Diminished inotropic response of aged myocardium to catecholamines. Circ Res 36:262–269, 1975.
Lakatta EG. Alterations in the cardiovascular system that occur in advanced age. Fed Pro 38:163–167, 1979.
Fleg JL, Tzankoff SP, and Lakatta EG. Age-related augmentation of plasma catecholamines during dynamic exercise in healthy males. J Appl Physiol 59:1033–1039, 1985.
Palmer GP, Ziegler MG, and Lake CR. Response of norepinephrine and blood pressure to stress increases with age. J Gerontol 33:482–487, 1978.
Suggested Reading
Weisfeldt ML. Aging of the cardiovascular system (editorial). N Engl J Med 303:1172–1174, 1980.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1987 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Fleg, J.L., Gerstenblith, G., Lakatta, E.G. (1987). Pathophysiology of the Aging Heart and Circulation. In: Messerli, F.H. (eds) Cardiovascular Disease in the Elderly. Developments in Cardiovascular Medicine, vol 76. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-9925-4_2
Download citation
DOI: https://doi.org/10.1007/978-1-4684-9925-4_2
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4684-9927-8
Online ISBN: 978-1-4684-9925-4
eBook Packages: Springer Book Archive