Cardiovascular Effects of Ageing

Describe the cardiovascular changes that occur with ageing.

CVS effects of ageing can be divided into cardiac, vascular, and autonomic changes:

  • Cardiac changes
    • Decreased receptor density and number
    • Decreased maximum heart rate
      Due to fibrosis of the SA node causing reduced pacemaker cell number and funtion, and reduction in catecholamine receptor density.
    • Decreased inotropy
      Minor.
    • Increased reliance on atrial kick
      Reduced ventricular compliance increases the reliance on atrial kick to achieve adequate preload.
    • Decreased diastolic compliance
      • Due to hypertrophy from increased afterload
  • Vascular changes
    • Reduced compliance
      Due to loss of elastic tissue in the large arteries.
    • Increased SVR
      Reduced compliance results in increased vascular resistance.
    • Reduced endothelial cell function (decreased NO)
      Impairs the ability of the vascular tree to adapt to changes in pressure/volume leading to:
      • Elevated SBP
      • Reduced DBP
        Reduced elastic recoil causes diastolic run off and a fall in diastolic blood pressure.
    • Reduced catecholamine receptor density
      Reduced responsiveness to (and increased number of) circulating catecholamines.
  • Autonomic
    • Impaired autonomic function
      Due to decreased catecholamine responsiveness.
    • Impaired baroreceptor response
    • Decreased exercise tolerance
      Reliance on preload to maintain cardiac output.

References

  1. ANZCA February/April 2016
  2. Cheitlin MD. Cardiovascular physiology-changes with aging. Am J Geriatr Cardiol. 2003 Jan-Feb;12(1):9-13.
Last updated 2018-07-14

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