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Cardiac Alterations in Aging, Hypertension, and Diastolic Heart Failure

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Aging and Heart Failure

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Abstract

Cardiovascular disease (CVD) is the leading cause of death globally, with an estimated 17.3 million people dying of CVDs in 2008. Age is a major independent risk factor of CVD, in part due to progressive exposure to a variety of insults including smoking, obesity, hypertension (HTN), and chronic diseases. Population studies on aging demonstrate linear increases in systolic blood pressure throughout each decade of life. HTN is the most commonly identified modifiable risk factor in CVD and most notably is present in 74 % of patients with heart failure (HF). Importantly, age-adjusted incidence of HF has not declined substantially in the past 20–30 years, in spite of improvements in control of causal factors. Diastolic heart failure (DHF) is now understood to account for more than 50 % of HF cases in the elderly with outcomes equally dismal as those with systolic heart failure. Only recently has the interaction of CVD and physiologic effects of aging attracted attention; therefore, many aspects are yet to be elucidated. The aim of this chapter is to review key micro- and macroscopic cardiac alterations associated with aging, hypertension, and DHF and discuss fundamental treatment strategies.

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Abbreviations

BP:

Blood pressure

CVD:

Cardiovascular disease

DHF:

Diastolic heart failure

HF:

Heart failure

HTN:

Hypertension

LV:

Left ventricle

MMPs:

Matrix metalloproteinases

PICP:

Procollagen type 1 carboxyl-terminal propeptide

PIIICP PIIINP:

Carboxy-terminal and amino-terminal peptides of collagen type III

TIMPs:

Tissue inhibitors of matrix metalloproteinases

ROS:

Reactive oxygen species

SHF:

Systolic heart failure

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Authors and Affiliations

  1. Department of Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, Canada, T6G 1Z2

    Edith Pituskin PhD(c)

  2. Department of Cardiology/Medicine, Mazankowski Alberta Heart Institute, University of Alberta, 8440 112 Street, Room 2C2.43 WCM, Edmonton, AB, Canada, T6G 2B7

    D. Ian Paterson MD, FRCPC

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  1. Edith Pituskin PhD(c)
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Correspondence to D. Ian Paterson MD, FRCPC .

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Editors and Affiliations

  1. Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta and Hospitals, Edmonton, Alberta, Canada

    Bodh I. Jugdutt

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Pituskin, E., Paterson, D.I. (2014). Cardiac Alterations in Aging, Hypertension, and Diastolic Heart Failure. In: Jugdutt, B. (eds) Aging and Heart Failure. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0268-2_7

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