Cardiovascular Changes with Aging

  • Brian F. Johnson
  • Janice C. Hitzhusen


Changes in cardiovascular anatomy and function that are specifically due to aging are often difficult to distinguish because of the high prevalence of heart and blood vessel disease among the elderly in Western cultures. 1–4


Cardiac Output Mitral Valve Systolic Hypertension Aortic Distensibility Left Ventricular Wall Thickness 
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  1. 1.
    National Program to Conquer Heart Disease, Cancer, and Stroke. The President’s Commission, Washington, DC, 1964Google Scholar
  2. 2.
    Caird FI, Kennedy RD: Epidemiology of heart disease in old age, in Caird FI, Dall JLC, Kennedy RD (eds): Cardiology in Old Age. New York, Plenum Press, 1976, p 1.CrossRefGoogle Scholar
  3. 3.
    White NR, Edwards JE, Dry TJ: The relationship of the degree of coronary atherosclerosis with age. Circulation 1950; 1: 645–654.Google Scholar
  4. 4.
    Ackerman RF, Dry TJ, Edwards JE: Relationship of various factors to the degree of coronary atherosclerosis in women. Circulation 1950; 1: 1345–1354.PubMedGoogle Scholar
  5. 5.
    Kohn RR: Heart and cardiovascular system, in Finch CE, Hayflick L (eds): Handbook of the Biology of Aging. New York, van Nostrand Reinhold Co, 1977, p 281.Google Scholar
  6. 6.
    Wilens SL: The postmortem elasticity of the adult human aorta: Its relation to age and to the distribution of atheroma. Am J Pathol 1937; 13: 811–815.PubMedGoogle Scholar
  7. 7.
    Wellman WE, Edwards JE: Thickness of the media of the thoracic aorta in relation to age. Arch Pathol 1950; 50: 183–188.Google Scholar
  8. 8.
    Nakashina T, Tanikawa J: A study of human aortic distensibility with relation to atherosclerosis and aging. Angiology 1971; 22: 477–490.CrossRefGoogle Scholar
  9. 9.
    Avolio AP, Chen S, Wang R, et al: Effect of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. Circulation 1983; 68: 50–58.PubMedCrossRefGoogle Scholar
  10. 10.
    Uno H, Poff B: Coronary arterial ectasia, a predominant type of coronary sclerosis in aged captive rhesus monkeys (Macaca mulatta). Am J Pathol 1983; 111: 315–322.PubMedGoogle Scholar
  11. 11.
    Hallock P, Benson IC: Studies on the elastic properties of human isolated aorta. J Clin Invest 1937; 16: 595–602.PubMedCrossRefGoogle Scholar
  12. 12.
    Gribbin B, Pickering TG, Sleight P, et al: Effect of age and high blood pressure on baroreflex sensitivity in man. Circ Res 1971; 29: 424–431.PubMedGoogle Scholar
  13. 13.
    McGarry K, Laher MS, Fitzgerald DJ, et al: Baroreflex function in elderly hypertensives. Br Heart J 1981; 45: 620.CrossRefGoogle Scholar
  14. 14.
    Sulkin NM, Kunz A: Histochemical alterations in autonomic ganglion cells associated with aging. J Gerontol 1952; 7: 533.PubMedGoogle Scholar
  15. 15.
    Pomerance A: Pathology of the heart with and without cardiac failure in the aged. Br Heart J 1965; 27: 697–710.PubMedCrossRefGoogle Scholar
  16. 16.
    Smith HL: The relation of the weight of the heart to age and to the weight of the body. Am Heart J 1928; 4: 79.CrossRefGoogle Scholar
  17. 17.
    Hitzhusen JC, Alpert JS: The elderly heart: Special signs and symptoms to watch for. Geriatrics 1984; 39: 38–51.PubMedGoogle Scholar
  18. 18.
    McMillan JB, Leo M: The aging heart: I. Endocardium. J Gerontol 1959; 14: 268–283.Google Scholar
  19. 19.
    McMillan JB, Lev M: The aging heart. II. The valves. J Gerontol 1964; 19: 1–19.PubMedGoogle Scholar
  20. 20.
    Sell S, Scully RE: Aging changes in the aortic and mitral valves: Histologic and histochemical studies with observations on the pathogenesis of calcific aortic stenosis and calcification of the mitral annulus. Am J Pathol 1965; 46: 345–348.PubMedGoogle Scholar
  21. 21.
    Angrist A: Aging heart valves and a unitary pathology hypothesis for sclerosis. J Gerontol 1954; 19: 135–143.Google Scholar
  22. 22.
    Davies MJ, Pomerance A: Quantitative study of aging changes in the human sinoatrial node and internodal tracts. Br Heart J 1972; 34: 150–153.PubMedCrossRefGoogle Scholar
  23. 23.
    Das DN, Fleg JL, Lakatta EG: Effect of age on the components of atrioventricular conduction in normal humans. Am J Cardiol 1982; 49: 1031–1032.CrossRefGoogle Scholar
  24. 24.
    Lev M, Bharati S: Age-related changes in the cardiac conduction system. Intern Med 1981; 6: 19–37.Google Scholar
  25. 25.
    Yin FCP, Spurgeon HA, Weisfeldt ML, et al: Mechanical properties of myocardium from hypertrophied rat hearts: A comparison between hypertrophy induced by senescence and by aortic banding. Circ Res 1980; 46: 292–300.PubMedGoogle Scholar
  26. 26.
    Weisfeldt ML, Loeven WA, Shock NW: Resting and active mechanical properties of trabeculae carneae from aged male rats. Am J Physiol 1971; 220: 1921–1927.PubMedGoogle Scholar
  27. 27.
    Abu-Erreish GM, Neely JR, Whitmer JT, et al: Fatty acid oxidation by isolated perfused working hearts of aged rats. Am J Physiol 1977; 232: E258–E262.PubMedGoogle Scholar
  28. 28.
    Lakatta EG, Gerstenblith G, Angell CS, et al: Diminished inotropic response of aged myocardium to catecholamines. Circ Res 1975; 36: 262–269.PubMedGoogle Scholar
  29. 29.
    Guarnieri T, Filburn CR, Zitnik G, et al: Contractile biochemical correlates of betaadrenergic stimulation of the aged heart. Am J Physiol 1980; 239:HSO1–HSO8.Google Scholar
  30. 30.
    Guarnieri T, Spurgeon H, Froehlich JP, et al: Diminished inotropic response but unaltered toxicity to acetyl-strophanthidine in the senescent beagle. Circulation 1979; 60: 1548–1554.PubMedGoogle Scholar
  31. 31.
    Chesky J, Rockstein M: Reduced myocardial actomyosin adenosinetriphosphatase activity in the ageing male Rischer rat. Cardiovasc Res 1977; 11: 242–246.PubMedCrossRefGoogle Scholar
  32. 32.
    Carey R, Natarajan G, Bove A, et al: Myosin adenosine triphosphatase activity in the volume-overloaded hypertrophied feline right ventricle. Circ Res 1979; 45: 81–87.PubMedGoogle Scholar
  33. 33.
    Rockstein M, Chesky JA, Lopez T: Effects of exercise on the biochemical aging of mammalian myocardium. I. Actomyosin ATPase. J Gerontol 1981; 36: 294–297.PubMedGoogle Scholar
  34. 34.
    Rockstein M, Chesky J, Lopez T: Calcium sensitivity of myocardial actomyosin ATPase in young and mature male Fischer rats. A brief note. Mechanisms Aging Dev 1978; 8: 413–416.CrossRefGoogle Scholar
  35. 35.
    Wei JY, Spurgeon HA, Lakata EG: Transmembrane action potential duration and contractile activation are lengthened in cardiac muscle of senescent rats. Clin Res 1980; 28: 619A.Google Scholar
  36. 36.
    Wei JY, Spurgeon HA, Lakatta EG: Excitation-contraction in rat myocardium: alterations with adult aging. Am J Physiol 1984; 246: H784–H791.PubMedGoogle Scholar
  37. 37.
    Spurgeon HA, Steinbach MF, Lakatta EG: Chronic exercise prevents characteristic age-related changes in rat cardiac contraction. Am J Physiol 1983; 244: H513–H518.PubMedGoogle Scholar
  38. 38.
    Froehlich JP, Lakatta EG, Beard E, et al: Studies of sarcoplasmic reticulum function and contraction duration in young and aged rat myocardium. J Mol Cell Cardiol 1978; 10: 472–488.CrossRefGoogle Scholar
  39. 39.
    Yin FCP, Weisfeldt ML, Milnor WR: Role of aortic input impedance in the decreased cardiovascular response to exercise with aging in dogs. J Clin Invest 1981; 68: 28–38.PubMedCrossRefGoogle Scholar
  40. 40.
    Kannel WB, Gordon T, Schwartz MJ: Systolic versus diastolic blood pressure and risk of coronary heart disease. The Framingham Study. Am J Cardiol 1971; 27: 335–346.PubMedCrossRefGoogle Scholar
  41. 41.
    Kannel WB, Gordon T: Evaluation of the cardiovascular risk in the elderly: The Framingham study. Bull NY Acad Med 1978; 54: 573–591.Google Scholar
  42. 42.
    National Center for Health Statistics: Blood pressure of adults by age and sex: United States, 1960–1962. Public Health Service Publication No 1000, Series 11, No. 4. Washington, DC, Government Printing Office, 1964.Google Scholar
  43. 43.
    Koch-Weser J: Correlation of pathophysiology and pharmacotherapy in primary hypertension. Am J Cardiol 1973; 32: 499–510.CrossRefGoogle Scholar
  44. 44.
    Kannel WB, Wolf PA, Verter J, et al: Epidemiologic assessment of the role of blood pressure in stroke: The Framingham Study. JAMA 1970; 214: 301–310.Google Scholar
  45. 45.
    Kannel WB, Castelli WP, McNamara PM, et al: Role of blood pressure in the development of congestive heart failure: The Framingham Study. N Engl J Med 1972; 287: 781–787.PubMedCrossRefGoogle Scholar
  46. 46.
    Swales JD: Pathophysiology of blood pressure in the elderly. Age Aging 1981; 8: 104–112.CrossRefGoogle Scholar
  47. 47.
    Weidmann P, DeMyttenaere-Burszteins M, DeLima J: Effect of ageing on plasma renin and aldosterone in normal man. Kidney Int 1975; 8: 325–333.PubMedCrossRefGoogle Scholar
  48. 48.
    Esler M: Age-dependence of noradrenaline kinetics in normal subjects. Clin Sci 1981; 60: 217.PubMedGoogle Scholar
  49. 49.
    Hickler RB: Aging and hypertension: Hemodynamic implications of systolic pressure trends. J Am Geriatr Soc 1983; 31: 421–425.PubMedGoogle Scholar
  50. 50.
    Caird FI, Andrews GR, Kennedy RD: Effect of posture on blood pressure in the elderly. Br Heart J 1973; 35: 527–530.PubMedCrossRefGoogle Scholar
  51. 51.
    Master AM, Oppenheimer ET: A simple exercise tolerance test for circulatory efficiency with standard tables for normal individuals. Am J Med Sci 1929; 177: 223–243.CrossRefGoogle Scholar
  52. 52.
    Dehn MM, Bruce A: Longitudinal variations in maximal oxygen uptake with age and activity. J Appl Physiol 1972; 33: 805–807.PubMedGoogle Scholar
  53. 53.
    Robinson S, Dil DB, Ross JC, et al: Training and physiological aging in man. Fed Proc 1973; 32: 1628–1634.PubMedGoogle Scholar
  54. 54.
    Hodgson JL, Buskirk ER: Physical fitness and age, with emphasis on cardiovascular function in the elderly. J Am Geriatr Soc 1977; 25: 385–392.PubMedGoogle Scholar
  55. 55.
    Brandfonbrener M, Landowne M, Shock NW: Changes in cardiac output with age. Circulation 1955; 12: 557–566.PubMedGoogle Scholar
  56. 56.
    Granath A, Jonsson B, Strandell T: Circulation in healthy old men, studied by right heart catheterization at rest and during exercise in supine and sitting position. Acta Med Scand 1964; 176: 425–446.PubMedCrossRefGoogle Scholar
  57. 57.
    Julius S, Amery A, Whitlock LS, et al: Influence of age on the hemodynamic response to exercise. Circulation 1967; 36: 222–230.PubMedGoogle Scholar
  58. 58.
    Gerstenblith G, Lakatta EG, Weisfeldt ML: Age changes in myocardial function and exercise response. Prog Cardiovasc Dis 1976; 19: 1–21.PubMedCrossRefGoogle Scholar
  59. 59.
    Gerstenblith G, Frederiksen J, Yin FCP, et al: Echocardiographic assessment of a normal adult aging population. Circulation 1977; 56: 273–278.PubMedGoogle Scholar
  60. 60.
    Gardin JM, Henry WL, Savage DD, et al: Echocardiographic measurements in normal subjects: evaluation of an adult population without clinically apparent heart disease. J Clin Ultrasound 1979; 7: 439–447.PubMedCrossRefGoogle Scholar
  61. 61.
    Wroblewski T, Szlachcic-Brynczak J: Left ventricular wall motion determined by echocardiography in elderly subjects. Acta Physiol 1980; 31: 47–51.Google Scholar
  62. 62.
    Hitzhusen JC, Hickler RB, Pape LA, et al: Left ventricular dimensions and function in a healthy elderly population: A 2-dimensional echocardiographic study. Gerontologist 1982; 22: 119.Google Scholar
  63. 63.
    Sainsbury R, White T, Wray R: Echocardiography in elderly patients with systolic murmurs. Age Aging 1981; 10: 225–230.CrossRefGoogle Scholar
  64. 64.
    Miyatake K, Okamoto M, Kinoshita N, et al: Augmentation of atrial contribution to left ventricular inflow with aging as assessed by intracardiac Doppler flowmetry. Am J Cardio 1984; 53: 586–589.CrossRefGoogle Scholar
  65. 65.
    Learoyd BM, Taylor MG: Alterations with age in the viscoelastic properties of human arterial walls. Circ Res 1966; 18: 278–292.PubMedGoogle Scholar
  66. 66.
    Bailey IK, Griffith LSC, Rouleau J, et al: Thallium 201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease. Circulation 1977; 55: 79–87.PubMedGoogle Scholar
  67. 67.
    Botvinick EH, Tardash MR, Shames DM, et al: Thallium 201 myocardial perfusion scintography for the clinical clarification of normal, abnormal, and equivocal electrocardiographic stress tests. Am J Cardiol 1978; 41: 43–59.PubMedCrossRefGoogle Scholar
  68. 68.
    Ritchie JL, Trobaugh GB, Hamilton GW: Myocardial imaging with thallium 201 at rest and during exercise. Comparison with coronary arteriography and resting and stress electrocardiography. Circulation 1977; 56: 66–71.PubMedGoogle Scholar
  69. 69.
    McGowan RL, Martin ND, Zaret BL: Diagnostic accuracy of noninvasive myocardial imaging for coronary artery disease: an electrocardiographic and angiographic correlation. Am J Cardiol 1977; 40: 6–10.PubMedCrossRefGoogle Scholar
  70. 70.
    Tiefenbrunn AJ, Biello DR, Geltman EM, et al: Gated cardiac blood pool imaging and thallium 201 myocardial scintography for detection of remote myocardial infarction. Am J Cardiol 1981; 47: 1–6.PubMedCrossRefGoogle Scholar
  71. 71.
    Hitzhusen JC, Hickler RB, Alpert JS, et al: Exercise testing and hemodynamic performance in healthy elderly persons. Am J Cardiol 1984; 54: 1082–1086.PubMedCrossRefGoogle Scholar
  72. 72.
    Slutsky R, Karliner J, Ricci D, et al: Response of left ventricular volume to exercise in man assessed by radionuclide equilibrium angiography. Circulation 1979; 60: 565–571.PubMedGoogle Scholar
  73. 73.
    Borer JS, Bachrach SL, Green MV: Real-time radionuclide cineangiography in the noninvasive evaluation of global and regional left ventricular function at rest and during exercise in patients with coronary artery disease. N Engl J Med 1979; 296: 839–843.CrossRefGoogle Scholar
  74. 74.
    Sorenson SG, Ritchie JL, Caldwell JH, et al: Serial exercise radionuclide angiography: validation of count derived changes in cardiac output and quantitation of maximal exercise ventricular volume change after nitroglycerin and propranolol in normal men. Circulation 1980; 61: 600–609.Google Scholar
  75. 75.
    Borer JS, Kent KM, Bacharach SL, et al: Sensitivity, specificity and predictive accuracy of radionuclide cineangiography during exercise in patients with coronary artery disease: Comparison with exercise electrocardiography. Circulation 1979; 60: 572–580.PubMedGoogle Scholar
  76. 76.
    Port S, Frederick RC, Coleman RE, et al: Effect of age on the response of the left ventricular ejection fraction to exercise. N Engl J Med 1980; 303: 1133–1137.PubMedCrossRefGoogle Scholar
  77. 77.
    deVries HA: Physiological effects of an exercise training program upon men aged 52–88. J Gerontol 1970; 25: 325–336.Google Scholar
  78. 78.
    Adams GM, deVries HA: Physiological effects of an exercise training regimen upon women aged 52–79. J Gerontol 1973; 28: 50–55.PubMedGoogle Scholar
  79. 79.
    Poliner LE, Dehmer GJ, Lewis SE, et al: Left ventricular performance in normal subjects: A comparison of the responses to exercise in the upright and supine positions. Circulation 1980; 62: 528–534.PubMedGoogle Scholar
  80. 80.
    Bar-Shiomo B, Druck MN, Morch JE, et al: Left ventricular function in trained and untrained healthy subjects. Circulation 1982; 65: 484–488.CrossRefGoogle Scholar
  81. 81.
    Weiss JL, Weisfeldt ML, Mason SJ, et al: Evidence of Frank-Starling effect in man during severe semisupine exercise. Circulation 1979; 59: 655–661.PubMedGoogle Scholar
  82. 82.
    Stein RA, Michielli D, Diamond J, et al: The cardiac response to exercise training: Echocardiographic analysis at rest and during exercise. Am] Cardiol 1980; 46: 219–225.CrossRefGoogle Scholar
  83. 83.
    Rodeheffer RJ, Gerstenblith G, Becker LC, et al: Exercise cardiac output is maintained with advancing age in healthy human subjects: Cardiac dilatation and increased stroke volume compensate for diminished heart rate. Circulation 1984; 69: 203–213.PubMedCrossRefGoogle Scholar
  84. 84.
    Gilbert CA, Nutter CO, Feiner JV, et al: Echocardiographic study of cardiac dimensions and function in the endurance-trained athlete. AmJ Cardiol 1977; 40: 528–533.CrossRefGoogle Scholar
  85. 85.
    Bertel O, Buhler FR, Kiowski W, et al: Decreased beta-adrenoreceptor responsiveness as related to age, blood pressure, and plasma catecholamines in patients with essential hypertension. Hypertension 1980; 2: 130–138.PubMedGoogle Scholar
  86. 86.
    Fleg JL, Kennedy HL: Cardiac arrhythmias in a healthy elderly population. Detection by 24-hour ambulatory electrocardiography. Chest 1982; 81: 301–307.CrossRefGoogle Scholar
  87. 87.
    Nelson RD, Ezri MD, Denes P: Arrhythmias and conduction disturbances in the elderly, in Messerli FH (ed); Cardiovascular Disease in the Elderly. Boston, Martinus Nijhoff Publishing, 1984, p 83.Google Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • Brian F. Johnson
    • 1
  • Janice C. Hitzhusen
    • 1
  1. 1.Divisions of Clinical Pharmacology and GeriatricsUniversity of Massachusetts Medical CenterWorcesterUSA

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