Aging of the heart and circulatory system is one aspect of the aging of the entire human body. The cardiovascular system, like all organs and systems, gradually and gently begins to work worse and worse. There are times when the line between normal aging and disease is thin, then it is difficult to tell which changes are due to age and which are due to the developing disease. Find out what happens to the cardiovascular system over the years and how these changes affect the incidence of cardiovascular disease in seniors.
The aging process of the heart and circulatory system begins very quickly, between the ages of 30 and 40, and progresses slowly but gradually. This applies to all tissues and organs. It is up to us - our lifestyle: diet, physical activity, prevention and treatment of diseases - it depends on how quickly this process will reach the next stages.
Contents:
- Aging of blood vessels
- Aging heart
There are three basic changes in the circulatory system: arterial stiffness, fibrosis of the conduction system and hypertrophy of the connective tissue of the heart muscle. In the case of normal aging, none of these changes is sufficient to cause cardiovascular pathology. Nevertheless, they favor their development and in the event of additional factors, it is much easier to develop the disease.
Of course, the aging process is multi-faceted, the changes described above are one of many. It should also not be forgotten that it affects all systems, and their changes (especially the respiratory and nervous systems) indirectly also affect the heart and vessels.
Aging is a constant, slowly progressing deterioration in the functioning of the human body - reducing the functional reserves of systems and organs and deteriorating the delicate balance of processes taking place in our body. This is of course related to the "wear and tear" of organs, enzymes and body structures, and it is initially noticeable only at the time of maximum stress - exercise, stress or diseases.
With time, however, these changes are more and more noticeable. The aging process is natural, normal and completely physiological, so it does not cause disease or pathology by itself, but it can contribute to it. This is if aging does occurfaster than natural or very advanced, then a slight disturbance in the stability of the body's metabolism leads to the appearance of diseases. As a result, diseases of many organs and systems, including the cardiovascular system, are present. Age-related changes in the circulatory system result from several basic changes caused by aging:
- From the overgrowth of the connective tissue and fat cells of the heart's conduction system, which is responsible for stimulating the heart to contract
- From the growth of connective tissue, the amount of collagen and the appearance of amyloid deposits within the heart muscle, which affects its contractility and susceptibility to relaxation,
- Reducing the amount of elastic fibers, increasing the amount of collagen and calcification in the walls of arteries.
Aging of blood vessels
The last of these processes leads to stiffening of the arteries and reducing their compliance and flexibility, which in turn disrupts the process of receiving and transmitting energy.
Under normal circumstances, some of the energy from contraction of the heart muscle, in addition to pumping out blood, is transferred to the aortic wall, causing it to expand locally, which spreads along with the vessel. This deformation is called the pulse wave, and it facilitates the pumping of blood in such a way that the energy invested in the deformation of the vessel is gradually released, improving the efficiency of blood flow.
If the arterial wall becomes stiffer, the efficiency of this process decreases, the heart is forced to work harder, which leads to an increase in blood pressure and the heart muscle remodeling. Moreover, with age, the ability of the arteries to relax fades, resulting on the one hand from the changes described, and on the other hand from reduced sensitivity to vasodilators.
All this leads to an increase in blood pressure, especially systolic pressure (the first of the measured values).
Despite the described changes, under normal conditions, the pressure values remain correct, even at a very advanced age. However, if, in addition, any other triggering factor (e.g. obesity, stress, lack of physical activity) appears in the body, it results in the development of arterial hypertension - one of the most common diseases in the elderly.
It is also worth knowing that with age, the amount of water in the body decreases, it indirectly affects the circulatory system by slightly reducing the volume of circulating blood. This is one of the mechanisms that prevent the development of arterial hypertension despite the stiffening of the arterial walls. Dishesare changed, but the volume of blood inside them decreases, so the pressure remains at a similar level. However, lower water content increases the risk of dehydration in seniors.
Older age also affects the coagulation system: the balance between clotting and its inhibition is disturbed, which slightly increases the risk of venous thrombosis.
Aging heart
Changes in the heart muscle, including an increase in the amount of connective tissue, lead to diastolic disorders, and therefore filling with blood, hence the filling of the ventricles during contraction is less than normal and the heartbeat becomes ineffective.
Additionally, when you take into account the weakening of the compliance of the arteries and the resulting increased heart rate, it is easy to imagine a situation where the heart muscle overgrows in response to a greater workload. Therefore, the elderly more often develop the so-called heart failure with a preserved ejection fraction, which is characterized by normal contraction, but inappropriate diastole resulting, for example, from thickening of the walls.
Another change is the "aging" of the conductive system, which is responsible for the creation and distribution of impulses that stimulate the heart to contract. Typically, the amount of adipose and fibrous tissue within this system increases, leading to functional disorders, which results in a reduction in the number of contractions at rest, a reduction in the response of the conductive stimulus system to the momentary need to increase the number of contractions and the maximum number of pulses that can be generated.
Such changes have a twofold effect, on the one hand they intensify the tendency to the so-called orthostatic hypotension, i.e. dizziness and weakness that occurs immediately after changing the position of the body (e.g. after getting out of bed). It is also the cause of reduced exercise tolerance - due to the lower achievable heart rate during exercise compared to young people.
The cardiovascular response to stress also becomes less effective. It is worth knowing that fibrosis of the conduction system can eventually lead to so-called heart blocks, which disrupt the synchronization of contractions between the atria and the ventricles, in which case a pacemaker is required.
The aforementioned amyloid deposits are abnormal, amorphous protein deposits that are not harmful in themselves, but if they are abundant, they can damage the structure and function of the tissues in which they are found. For example, in the atria of the heart, in combination with fibrosis and many other factors,favors the occurrence of atrial fibrillation, i.e. irregular electrical activity and ineffective contraction.
Similar degenerative changes: Fibrosis, amyloid and calcium deposition degenerate and damage the heart valves, this is a natural process but progresses faster in some people. The result is valve disease, including the most common in the elderly - aortic valve stenosis (aortic stenosis).
Heart failureAll the processes described above are conducive to the occurrence of heart failure, i.e. a set of symptoms resulting from the weakening of this organ. The strength of the heart muscle is not sufficient for many reasons. As mentioned, diastolic failure is especially common in the elderly. Under the age of 60, it occurs in about 6% of patients, and in 80-year-olds it accounts for half of all heart failure cases.