The cardiovascular system undergoes predictable and progressive changes throughout life. These changes increase the risk of cardiovascular diseases in older adults. This process involves genetic factors, environmental influences, and lifestyle choices.
Age-related changes in the heart
Even in healthy individuals, the heart muscle undergoes several changes with age.
- Left Ventricular (LV) Hypertrophy: The left ventricle wall often thickens with age, partly in response to increased arterial stiffness and higher blood pressure. This can reduce the amount of blood the ventricle can hold.
- Diastolic Dysfunction: The heart's ability to relax and fill with blood declines. This leads to slower early filling and increased reliance on the left atrium to pump blood into the ventricle.
- Reduced Maximum Heart Rate: Changes in the heart's natural pacemaker lead to a slower resting heart rate and a significantly reduced maximum heart rate during activity. The heart's response to stress is also blunted.
- Valvular Thickening and Stiffening: Heart valves, especially the aortic valve, can thicken and become stiffer due to changes in connective tissue and calcification.
Age-related changes in blood vessels
Blood vessels also change with age, contributing to many age-related cardiac issues.
- Arterial Stiffening: Large arteries become thicker, stiffer, and less elastic due to changes in proteins and calcium deposits in the walls. This reduces their ability to manage blood pressure.
- Increased Blood Pressure: Arterial stiffness contributes to higher systolic blood pressure and pulse pressure, making the heart work harder.
- Endothelial Dysfunction: The inner lining of blood vessels becomes less functional, impairing blood flow regulation. Chronic inflammation also increases with age and affects endothelial function.
- Decreased Baroreceptor Sensitivity: Nerves that regulate blood pressure become less sensitive, increasing the risk of dizziness upon standing.
Comparative summary: Aging heart vs. younger heart
This table summarizes the key physiological differences between a healthy younger heart and a healthy aged heart at rest.
| Feature | Young Heart | Aged Heart |
|---|---|---|
| Arterial Stiffness | Low; elastic arteries effectively dampen pressure wave. | High; stiff arteries offer greater resistance, increasing workload. |
| Resting Heart Rate | Normal range (e.g., 60-100 bpm). | Slightly slower, or in normal range. |
| Maximal Heart Rate | High; increases substantially with exercise. | Lower; blunted response to exercise and stress. |
| Left Ventricular Wall | Normal thickness. | Thicker, due to concentric hypertrophy. |
| Diastolic Function (Filling) | Efficient early filling; less reliance on atrial kick. | Impaired early filling; increased reliance on atrial contraction. |
| Baroreceptor Sensitivity | High; rapid adjustment to blood pressure changes. | Lower; increased risk of orthostatic hypotension. |
Conclusion
Normal aging leads to widespread changes in the cardiovascular system, affecting the heart muscle, valves, and blood vessels. These adaptations reduce the system's reserve capacity, especially during stress. While this increases the risk of heart disease, lifestyle interventions like exercise, a healthy diet, and stress management can help slow cardiovascular aging. For further reading on cardiac changes associated with vascular aging, see {Link: PubMed Central https://pmc.ncbi.nlm.nih.gov/articles/PMC7021646/}.
