Transcript Normal Cardiovascular Changes

3-14-05
Aging & the
Cardiovascular System
Content for this module provided by
The John A. Hartford Foundation, Institute for
Geriatric Nursing, Online Gerontological
Nursing Certification Review Course
http://www.nyu.edu/education/nursing/hartford.institute/course/
Support for this project provided to School of Nursing, University of
Washington by the John A. Hartford Foundation, Geriatric Nursing
Education Grant and Nursing School Geriatric Investment Program Grant.
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Normal Cardiovascular
Changes
Difficult to differentiate
between age-related
changes and those
related to an inactive
lifestyle or disuse
Are the changes normal
'wear and tear' or
cardiovascular
disease?
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Normal Heart Muscle
Changes
Anatomical changes
• Thickening of the left
ventricular wall
•  collagen,  elastin
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Normal Heart Valve Changes
Anatomical changes
Mitral valve
•  thickness
•  flexibility
• Aortic & mitral valve
calcification
Aortic valve
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Normal SA Node & Intranodal
Atrial Tract Changes
Anatomical changes
•  # of pacemaker cells
• Fibrous tissue infiltration of
conductive system
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Normal Artery Changes
Anatomical changes
• Peripheral arteries less
resilient
• Large arteries stiffer, less
elastic,  elastin
• Calcifications in artery walls,
including aorta
• Calcifications +  elastin + 
collagen = stiffer vessels =
more difficult to dilate
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Normal Vein Changes
Anatomical changes
• Veins dilate & stretch with 
elasticity
– Intima & muscular walls
thicken and become less
elastic
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Normal Coronary Artery
Changes
• Coronary artery blood flow 
between ages 20 & 60
• Effect:  oxygen delivery to
the heart muscle, thus 
ability to increase activity
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Normal Changes: Aorta
• May become dilated,
elongated, rigid
• May develop calcifications
and become tortuous
•  elastin,  collagen =
calcification
=  stiffness,  compliance
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Normal Cardiovascular
Physiologic Changes
Summary - changes occur in:
– heart rate
– blood pressure
– myocardial function
– cardiac output
– valvular function
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Normal Cardiac Output
Changes
Decreased cardiac output in
response to exercise or
stress
(effects are influenced by
associated heart disease & level
of baseline physical activity)
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Normal Valvular Function
Changes
Systolic and diastolic
murmurs may result from
incomplete valve closures
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Normal Myocardial Function
Changes
•  contractile strength &
efficiency
•  cardiac output
•  cardiac reserve
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Normal Heart Rate Changes
 cardiac responsiveness
rate with exercise
Heart may take longer to
return to baseline rate
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Normal SA Node & Intranodal
Atrial Tract Changes
Physiological changes
Irritability of the myocardium may
result in extra systoles, along with
sinus arrhythmias & sinus bradycardia
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Normal Blood Pressure
Changes
Systolic blood pressure may
rise disproportionately higher
than diastolic
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CV Links to Other Organs
Changes in the cardiovascular system have
direct effects on other organs
Example: atherosclerotic changes in blood
vessels that occur in patients with
hypertension may result in loss of renal
function, vision impairment
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Functional Implications of
Normal Age-Related Changes*
•  response to stress
• Activity intolerance
• Orthostatic hypotension
– Dizziness w/position changes
*Influenced by presence of disease & lifestyle
variations
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Modifiable CV Risk Factors
• Hypertension
• Physical inactivity
• Smoking
• Obesity
• Dyslipidemia
• Stress
– low HDL
– elevated LDL
– elevated triglycerides
• Diabetes mellitus
• Post-menopausal
hormone therapy
• Excess alcohol
intake
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Nursing Interventions
Normal aging changes may be difficult to
differentiate from changes r/t inactive
lifestyle and/or CV disease
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Nursing Interventions
• Education about cardiovascular risk
factors, preventive measures & treatment
regimens
• Physical activity & smoking cessation are
interventions that have impacts on CV
health, as well as general health & healthy
aging