Cardiovascular

Age related changes:

  • Myocardium

    • decreased contractility

    • more diastolic filling time is required and for systolic emptying

    • less responsive to sympathetic nervous system

    • less pace maker cells, irregularity in shape, increased deposits of fat, collagen and elastic fiber around SA node

  • Vasculature

    • changes in tunica intima and tunica media

    • irregular endothelial cells

    • diameter of aorta increases to compensate for aterial stiffening

    • veins becomes thicker, dilated, and less elastic

    • increased vascular resistance, increase in systolic BP

Consequences of age related changes

  • decreased adaptive response to exercise

  • slightly lower heart rate

  • Increased susceptibility to hyper and hypo tension 

  • Increased susceptibility to arrhythmias 

  • Decreased cerebral blood flow 



    Pathological Risk Factors Affecting Cardiovascular function 

    • Arrhythmias 

    • Heart failure 

    • MI 

    • PVD ( peripheral vascular disease)

    • Venous thromboembolism 

    • Stroke 

    • Transient ischemic attack 

    • Atherosclerosis 

               - Plaque (lipids)  deposition in arteries, reducing/ obstructing blood flow


    Modifiable Risk affecting cardiovascular function: 

    • Physical inactivity 

    • Smoking and secondhand smoking 

    • Dietary habits 


    • Intake of grains, fish, fruit, vegetables, low sodium intake -> reduction of CV disease 

    • High intake of saturated fats increases risk of CV diseases 


    Orthostatic hypotension: 

    • Reduction in systolic BP and diastolic BP of 10 -20 mmhg within 1-3 minutes of standing after being recumbent for at least 5 minutes 

    • Higher in hospitalised older adults 

    • Risk increased by combination of additional conditions ( parkinson disease and anti-parkinson medication) 

    • symptoms : fatigue, blurred vision, lightheadedness, syncope upon standing 


    Postprandial Hypotension: 

    • Reduction in systolic BP of 20mmHg or more within 2 hours of eating 

    • Affects older adults with hypertension 

    • Impaired autonomic function 

    • Contributing factors: 

    • GI vasoactive peptides 

    • Impaired glucose metabolism/ diabetes