Biology of Aging and Implications for Heart Failure Therapy and Prevention

  • Bodh I. JugduttEmail author


The elderly population (age ≥65 years) with heart failure (HF) has been increasing in developed countries since the 1970s and is currently increasing in most developing countries. This growing burden of HF threatens to tax healthcare systems worldwide. Aging is a natural biological process that is progressive and is associated with cardiovascular (CV) changes that impact disease expression and response to therapy. Aging results in increased risk of CV disease (CVD), including HF. Several markers correlate with the aging phenotype. Low telomerase activity and telomere shortening may be early markers of risk. Importantly, several biological changes contribute to adverse CV remodeling and the march to HF during aging. The remodeling is global, involving changes in structure as well as biochemical, cellular, molecular, physiological, and pathophysiological pathways. These changes have important therapeutic implications. HF therapy that is optimal for the young may not be optimal for the old. Prevention of HF in the elderly should be a healthcare priority and preventive strategies are urgently needed. For optimal impact, the strategies should consider the aging-HF continuum and cumulative impact of lifelong exposure to CVD risk factors and the associated pathobiology and pathophysiology of aging. Besides implementation of conventional primary and secondary prevention measures in young and older adults, more emphasis should be placed on education about the role of exposure to adverse CVD risk factors from early childhood in the march to HF. More research is also needed to identify optimal HF therapies for different aging subgroups ranging from young adults to the elderly and very old based on understanding of pathobiology and pathophysiology.


Heart Failure Telomere Length Framingham Risk Score Heart Failure Hospitalization Heart Failure Management 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work was supported in part by grant # IAP-99003 from the Canadian Institutes of Health Research, Ottawa, Ontario. I am indebted to Catherine Jugdutt for her assistance.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.2C2 W.C. Mackenzie Health Sciences Centre, Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart InstituteUniversity of Alberta and HospitalsEdmontonCanada

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