CV Changes With Aging

Advanced, Clinical Subspecialties

Elderly patients have an increased incidence of heart failure and cardiomyopathy. This is in part due to the increased incidence of ischemic coronary artery disease, hypertension, and diabetes leading to cardiomyopathy. However, it is important to differentiate between the pathological states that are more likely in the elderly population and the normal changes that take place with aging in normal, healthy patients. These include:

  • Structural changes:

  • Vascular stiffening, decreased compliance, and increased vascular intimal thickness leading to increased afterload

  • Increased LV wall thickness/fibrosis which may lead to diastolic dysfunction

  • Increased left atrial size and fibrosis of the conduction system leading to increased likelihood of atrial fibrillation/other atrial dysrhythmias

  • Increased valvular cusp thickening and sclerosis

  • Functional changes:

  • Decreased nitric oxide production and effect leads to systemic hypertension

  • Decreased sensitivity of Beta receptors, which leads to a compensatory increase in circulating norepinephrine release by the adrenal glands

  • Decrease in maximal heart rate or inotropic response to exercise, hypovolemia, or hypoxia


    Heart Fail Clin;2012 Jan;8(1):143-64

    [PubMed: 22108734]


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Jake Anderson, MD