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Cardiovascular, Cerebrovascular, and Renovascular Consequences of Ageing May Be Challenged

  • Timo E. StrandbergEmail author
Chapter
Part of the Practical Issues in Geriatrics book series (PIG)

Abstract

Most important lifestyle-related or environmental risk factors of early vascular ageing and chronic non-communicable diseases, include unhealthy diet, smoking, and physical inactivity. These contribute to traditional or medical risk factors including hypertension, hypercholesterolemia, obesity, and hyperglycemia, which are the downstream causes of cardio-, cerebro-, and reno-vascular diseases later in life. Furthermore, it is increasingly evident that the occurrence of common geriatric syndromes, including frailty and mild cognitive impairment can also be predicted by midlife risk factors. Knowledge of risk factor development during life course and benefits of evidence-based treatments should be better utilized in the long-term prevention of vascular diseases of old age. Appropriate and effective treatment of core risk factors (hypertension, hypercholesterolemia, obesity, physical inactivity) should be started in midlife, or before, in order to ensure healthy and functional ageing.

Keywords

Aged Geriatric syndromes Hypercholesterolemia Hypertension Prevention 

References

  1. 1.
    Kaplan H, Thompson RC, Trumble BC et al (2017) Coronary atherosclerosis in indigenous south American Tsimane: a cross-sectional cohort study. Lancet 389:1730–1739CrossRefGoogle Scholar
  2. 2.
    Den Dunnen WF, Brouwer WH, Bijlard E et al (2008) No disease in the brain of a 115-year-old woman. Neurobiol Aging 29:1127–1132CrossRefGoogle Scholar
  3. 3.
    Nilsson PM, Boutouyrie P, Laurent S (2009) Vascular aging. A tale of EVA and ADAM in cardiovascular risk assessment and prevention. Hypertension 54:3–10CrossRefGoogle Scholar
  4. 4.
    Green DJ, Hopman MTE, Padilla J et al (2017) Vascular adaptation to exercise in humans: role of hemodynamic stimuli. Physiol Rev 97:495–528CrossRefGoogle Scholar
  5. 5.
    Guzik TJ, Touyz RM (2017) Oxidative stress, inflammation, and vascular aging in hypertension. Hypertension 70:660–667CrossRefGoogle Scholar
  6. 6.
    Seals DR, Kaplon RE, Gioscia RA, LaRocca TJ (2014) You’re only as old as your arteries: translational strategies for preserving vascular endothelial function with aging. Physiology 29:250–264CrossRefGoogle Scholar
  7. 7.
    Goldstein JL, Brown MS (2015) A century of cholesterol and coronaries: from plaques to genes to statins. Cell 161:161–172CrossRefGoogle Scholar
  8. 8.
    Ference BA, Ginsberg HN, Graham I et al (2017) Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J 38(32):2459–2472.  https://doi.org/10.1093/eurheartj/ehx144 [Epub ahead of print]CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Kahn JA, Glueck CJ (1978) Familial hypobetalipoproteinemia. Absence of atherosclerosis in a postmortem study. JAMA 240:47–48CrossRefGoogle Scholar
  10. 10.
    Poulter NR, Probhakaran D, Caulfield M (2015) Hypertension. Lancet 386:801–812CrossRefGoogle Scholar
  11. 11.
    WHO (2015) World report on ageing and health. WHO, GenevaGoogle Scholar
  12. 12.
    Prince MJ, Guo Y, Gutierrez Robledo LM et al (2015) The burden of disease in older people and implications for health policy and practice. Lancet 385:549–546CrossRefGoogle Scholar
  13. 13.
    Raitakari OT, Juonala M, Kähönen M et al (2003) Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the cardiovascular risk in young Finns study. JAMA 290:2277–2283CrossRefGoogle Scholar
  14. 14.
    Jousilahti P, Laatikainen T, Peltonen M et al (2016) Primary prevention and risk factor reduction in coronary heart disease mortality among working aged men and women in eastern Finland over 40 years: population based observational study. BMJ 352:i721.  https://doi.org/10.1136/bmj.i721 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Fries JF (1980) Aging, natural death, and the compression of morbidity. N Engl J Med 303:130–135CrossRefGoogle Scholar
  16. 16.
    Inouye SK, Studenski S, Tinetti ME, Kuchel GA (2007) Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc 55:780–791CrossRefGoogle Scholar
  17. 17.
    Strandberg TE, Pitkälä KH, Tilvis RS et al (2013) Geriatric syndromes—vascular disorders? Ann Med 45:265–273CrossRefGoogle Scholar
  18. 18.
    Paulus Kirchhof P, Benussi S, Kotecha D (2016) 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37:2893–2962CrossRefGoogle Scholar
  19. 19.
    Strandberg TE, Pitkälä K, Tilvis RS (2011) Frailty in older people. Eur Geriatr Med 2:344–355CrossRefGoogle Scholar
  20. 20.
    Strandberg TE, Sirola J, Pitkälä KH et al (2012) Association of midlife obesity and cardiovascular risk with old age frailty: a 26-year follow-up of initially healthy men. Int J Obes 36:1153–1157CrossRefGoogle Scholar
  21. 21.
    Weintraub WS, Daniels SR, Burke LE et al (2011) Value of primordial and primary prevention for cardiovascular disease. A policy statement of the American Heart Association. Circulation 124:967–990CrossRefGoogle Scholar
  22. 22.
    US Preventive Services Task Force (2017) Behavioral counseling to promote a healthful diet and physical exercise for cardiovascular disease prevention in adults without cardiovascular risk factors. JAMA 318:167–174CrossRefGoogle Scholar
  23. 23.
    Lloyd-Jones DM, Hong Y, Labarthe D et al (2010) Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic impact goal through 2020 and beyond. Circulation 121:586–613CrossRefGoogle Scholar
  24. 24.
    Karmali KN, Lloyd-Jones DM, Berendsen MA et al (2016) Drugs for primary prevention of atherosclerotic cardiovascular disease. An overview of systematic reviews. JAMA Cardiol 1:341–349CrossRefGoogle Scholar
  25. 25.
    Andrieu S, Coley N, Lovestone S et al (2015) Prevention of sporadic Alzheimer’s disease: lessons learned from clinical trials and future directions. Lancet 14:926CrossRefGoogle Scholar
  26. 26.
    Bramlage P, Sims H, Minguet J, Ferrero C (2017) The polypill: an effective approach to increasing adherence and reducing cardiovascular event risk. Eur J Prev Cardiol 24(3):297–310CrossRefGoogle Scholar
  27. 27.
    Strandberg TE, Kolehmainen L, Vuorio A (2014) Evaluation and treatment of older patients with hypercholesterolemia. JAMA 312:1136–1144CrossRefGoogle Scholar
  28. 28.
    Benetos A, Rossignol P, Cherubini A et al (2015) Polypharmacy in the aging patient: management of hypertension in octogenarians. JAMA 314:170–180CrossRefGoogle Scholar
  29. 29.
    Wehling M, Collins R, Gil VM et al (2017) Appropriateness of oral anticoagulants for the long-term treatment of atrial fibrillation in older people. Drugs Aging 34:499–507CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Helsinki University Central HospitalUniversities of Helsinki and OuluHelsinkiFinland

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