Aging Effects The cardiovascular system is sometimes called the circulatory system because it is comprised of the heart, blood,

and blood vessels (arteries, veins, and capillaries). Because it is responsible for circulating oxygen and nutrients to all parts of the body, it is, understandably, one of the body systems most affected by age. The walls of the arteries thicken, lose their elasticity, and become stiffer. This causes a decrease in blood flow to vital organs and causes blood pressure to rise. Major age-related changes include the following:

Blood

A decreased hematocrit (the number of erythrocytes in the whole blood) can lead to anemia, as well as certain dietary deficiencies. Erythrocytes also help in the transport of oxygen and carbon dioxide and in maintaining a normal acid/base balance. Peripheral veins become constricted or blocked by the formation of stationary blood clots (thrombus). These can dislodge, causing an embolism in the lungs or an extremity, thus shutting down circulation. When this happens, it most often means an amputation. Because the valves in leg veins are often not able to work to capacity, blood often pools causing swelling of the lower extremities. One thing that does remain constant with age is the volume and composition of blood. This means that most lab values remain normal. Abnormal lab values for blood tests usually indicate alterations in other organ systems. For instance, fasting blood glucose level increases with aging but not as a result of changes in the blood. Rather, it is the result of age-related changes associated with insulin. The same holds true for serum lipids. While serum lipids increase 25-50% after the age of 55, the increase results from an altered metabolism and not to changes in the blood or blood-forming organs. The amount of red bone marrow decreases with age, causing a decline in the formation of new blood cells. Therefore, recovery from bleeding episodes will be slowed. Age-related decline also occurs in WBC (white blood cell) activity. Although WBC activity increases in response to infection, it does so more slowly. Cardiac muscle fibers and neurons cannot be replaced, and cumulative lapses result from even relatively minor damage.

Blood Vessels

Blood vessel walls become thicker and tougher. Since the walls no longer have the elasticity to adjust to sudden changes in blood pressure, there is an increased risk of aneurysms. As the inner surface of blood vessels become roughened, age-related changes cause an increased risk in the development of fatty plaques and of thrombus formation. Weakened vascular walls also collect calcium salts, which increase the risk of heart attack or stroke. As the walls of veins weaken and stretch, their valves become incompetent. This is more likely to occur in the legs where the walls are subject to greater pressure as the blood

struggles to return to the heart against the force of gravity. As a result, distended superficial veins develop (varicose veins). An inflammation, called phlebitis, also occurs more often in the elderly. Baroreceptors become less sensitive; therefore, adjustments to changes in position are slowed, causing an increase in dizziness and falling.

Heart

There is a reduction in exercise cardiac output. Because the heart is not able to pump the blood as efficiently, circulation is slowed. In addition, the heart cannot respond as quickly, or as forcefully, to the increased workload of the exercised heart. Exertion, sudden movements, and changes in position may cause a decrease in cardiac output, resulting in dizziness and loss of balance. However, opinions vary as to whether or not there are changes in the resting cardiac output. In general, heart resting output is decreased to 80% by age 50 and to 70% of capacity by age 70. When output does decline, it is often associated with such other age-related processes as atherosclerosis. A reduction in cardiac output leads to pooling of blood in the legs, cold extremities, and edema. The health of the myocardium (the hearts muscular wall) depends on blood supply, and with age, the likelihood of atherosclerosis increases, causing the coronary arteries to narrow, restricting the vital blood supply. High blood pressure (hypertension) causes the left ventricle to work harder. It may enlarge and outgrow its blood supply and thus becomes weaker. Several structural changes in the heart contribute to the impaired response to exercise: o heart muscle loses elasticity and becomes more rigid; o heart valves become thickened by fibrosis and more rigid (leading to murmurs); o the number of pacemaker cells decreases; o aging heart cells have a decreased ability to use oxygen; o arrhythmias are more common with age as the cells of the conduction pathway become less efficient. An age-related increase occurs in blood pressure. As a result, the heart needs to work harder to pump blood into the systemic circulation.

Aging & the Cardiovascular System Researchers at Merck report that the cardiovascular aging process differs in senior citizens, ranging from atrophy to enlarged atriums on the heart and thickening of the ventricular walls. Not all heart deterioration is part of the natural aging process; most heart disease is a result of poor lifestyle choices and other linked conditions.

Arteries
One of the natural phases the cardiovascular system goes through in the aging process is thickening of the artery walls. In time, the walls of the aorta and other large arteries become thick and elongated. The elastic membranes in the arteries become fragmented due to cellular

accumulation, which puts elderly people at risk for developing arteriosclerosis. Cholesterol deposits and changes in collagen also contribute to reduced elasticity of the artery walls.

Heart
The heart experiences age-related changes as well. Cardiac output is reduced as the fibrous tissues of the heart lose their elasticity. Fatty buildup and plaque slow circulation. At the same time, damaged heart muscles that have broken down over the years develop scar tissue on the heart, making it even less efficient.

Blood Flow
Researchers at Utah State University report that natural aging results in reduced blood flow throughout the body and is particularly evident after age 80. The heart muscles that pump oxygenated blood throughout the body atrophy, and the heart valves begin to calcify. Physical strength weakens with the reduced blood flow because less oxygen is being exchanged and there is reduced cellular nourishment. Kidney and liver function are reduced as well, resulting in a slower rate of healing and lower stress responses.

Blood Volume
A decrease in the blood volume of red blood cells is common during the aging process, report trainers at the American Academy of Health and Fitness. Blood clots often block or constrict peripheral veins as well. Blood often pools in the legs when the volume of blood is diminished and the valves aren't working properly. Gravity pulls the decreased blood levels to the lowest areas, resulting in a breakdown of the cardiovascular system.

Aerobic Capacity
Aerobic capacity between ages 20 and 80 decreases by an average of 50 percent, reports researchers at the American Academy of Health and Fitness. Although levels of peak capacity and ability are compromised with age, the level of deterioration varies depending on people's overall health and long-term exercise habits. Vascular stiffening is directly related to the physical conditioning of the elderly person and decreases by half in those who have maintained an active lifestyle versus sedentary seniors.

Geriatrics: Aging changes in Cardiovascular System (Heart and Blood Vessels) The cardiovascular system includes the heart which pumps the blood throughout the body and the network of blood vessels through which the blood is transported. In healthy people, the changes that normally occur in the cardiovascular system with aging do not significantly limit the normal work capacity of the heart. Most of the changes that cause clinically significant declines in cardiovascular function are the result of disease.

Heart Muscle As we age, the heart muscle becomes slightly stiffer and may increase slightly in size. Despite this slight increase in heart size, the amount of blood the chamber can hold may actually decrease because the heart wall thickens. The maximum heart rate (the highest rate at which your heart can pump) decreases even among the most fit athlete. However, the resting heart rate and the cardiac output (amount of blood pumped over a period of time) do not change. In response to stress or exertion, older adults compensate for their lower maximum heart rate by increasing their stroke volume (i.e., amount of blood pumped with each contraction of the heart) to maintain cardiac output. Among older adults it takes longer for the heart rate and blood pressure to return to normal resting levels following stress. Aorta and Other Blood Vessels Our blood vessels, including the aorta and other arteries also become stiffer and are less responsive to hormones that relax the blood vessel walls. The stiffening of blood vessels contributes to the increasing systolic blood pressure with aging observed in most cultures. In Western countries, systolic blood pressure tends to increase throughout a persons life span, while diastolic blood pressure rises until age 60 and then levels off. Nearly 50% of older adults have chronic hypertension. Increases in systolic blood pressure do not occur in many nonindustrialized societies which suggests that risk for hypertension is affected by environmental factors such as diet and lifestyle as well as heredity. Heart rate, Murmurs, and Hypotension Our heart rate may be slightly slower as we grow older due to a loss in the number of pacemaker cells. The electrical pathways may develop fibrous tissue and fat deposits that can make abnormal heart rythms more common. Shifts in the circulation of blood to various organs can also change-- the blood flow to the kidneys may decrease by 50 percent and to the brain by 15 to 20 percent. Heart murmurs are also common with age because our heart valves become less flexible and calcium deposits build up. Finally, the organs which monitor the blood pressure and adjust your blood pressure when you change position become less sensitive with aging. This can cause orthostatic hypotension (a condition where the blood pressure falls when you go from lying or sitting to standing) and cause dizziness when you change position. Therefore, if you (or your client) gets dizzy in the morning when getting out of bed, you should change position more slowly-- sit for a few minutes before standing up. Aging Gracefully: The Cardiovascular System Recognition and Prevention of Cardiovascular Trouble as You Age As we age, our bodies change. What is normal? What is not? This month, we look at the cardiovascular system to see how it ages. The cardiovascular system is complex and extends beyond our heart through arteries, veins and capillaries that carry blood throughout the body. With every heartbeat, these parts work hard to clean carbon dioxide from our blood and pump oxygen-filled blood to all parts of the body. Certain changes that take place within the cardiovascular system as we age are normal and not causes for concern. Other changes may be warning signals that, if missed, can have lifethreatening consequences. Knowing what these changes mean is the key element to identifying

what may be normal versus what could be an underlying symptom that requires medical advice or treatment. You should always consult your own doctor for medical advice, but following is a broad overview of some cardiovascular complications that, according to the Mayo Clinic, you may experience as you age:

High cholesterol causes fatty build-up within the arteries that can restrict blood flow and can cause coronary artery disease resulting in angina (typically, chest pains) or heart attack; usually has no symptoms until severe and requires bloodwork to detect early on. Coronary artery disease Develops when your coronary arteries become damaged or diseased. Often caused by fatty cholesterol build-up (plaques); can cause angina or heart attack; symptoms can include heart pain and shortness of breath; without testing cholesterol levels, coronary artery disease can go undetected until heart attack or stroke occurs. High blood pressure (hypertension) can lead to heart attack, congestive heart failure, stroke, kidney failure, peripheral artery disease and aortic aneurysms; usually undetectable without testing until severe, but symptoms can include dizziness, dull headaches and sometimes nosebleeds. Arteriosclerosis A type of coronary artery disease in which narrowed arteries reduce blood flow to your limbs; often caused by plaque build- up in the arteries; can lead to heart attack or stroke; symptoms may not be present until condition is severe and include numbness of limbs, chest pain, and leg pain when walking. Anemia caused by low red blood cell count and can cause fatigue, chest pains, irregular heartbeat, coldness of the hands and feet, and other symptoms. Abnormal heart rhythms (irregular heart beat) can be caused by a weak or damaged heart; some symptoms include a fluttering heart, shortness of breath, chest pain, lightheadedness, dizziness and fainting or near fainting; can be present in normal healthy adults or be a symptom of a deadly condition of ventricular fibrillation. Congestive heart failure can be caused by coronary artery disease, high blood pressure, diabetes, obesity and high cholesterol; symptoms include shortness of breath, fatigue, edema (swelling of hands and feet), irregular heartbeat, loss of appetite or nausea, or swelling of the abdomen.

Some of the symptoms caused by the conditions above can be considered normal or may not be related to the condition at all, but others can be life-threatening. It is vitally important to seek the help of your doctor to determine the severity of your symptoms and how they relate to your health. Signs and symptoms can vary from person to person depending on the overall health of each individual.
Pro-active Prevention

You do have control over some heart-related diseases such as high cholesterol, obesity, diabetes and high blood pressure, which can all lead to more serious medical conditions. The Mayo Clinic recommends the following eight heart-healthy diet steps to prevent heart disease :

Limit unhealthy fats and cholesterol Choose low-fat protein food sources

Eat more vegetables and fruits Select whole grains Reduce the salt in your food Control portion sizes Plan ahead to create healthy menus Allow yourself an occasional treat

1. With your health care providers approval, exercise regularly, within your capability. Regular exercise can reduce your chances of suffering from obesity, blood pressure issues, diabetes and heart disease. Eating a healthy diet and reducing fat intake can help control high cholesterol and fosters overall goeHow 2. Healthcare 3. Bone Health 4. Skeletal System 5. Changes in the Skeletal System Due to Age