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 function, 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: - Reduced catecholamine receptor density
Reduced responsiveness to (and increased number of) circulating catecholamines.
- Reduced compliance
- Autonomic
- Impaired autonomic function
Due to decreased catecholamine responsiveness. - Impaired baroreceptor response
- Decreased exercise tolerance
Reliance on preload to maintain cardiac output.
- Impaired autonomic function
References
- ANZCA February/April 2016
- Cheitlin MD. Cardiovascular physiology-changes with ageing. Am J Geriatr Cardiol. 2003 Jan-Feb;12(1):9-13.