The Aging Cardiovascular System
Open accessAbstract
Cardiovascular disease (CVD) presents a great burden for elderly patients, their caregivers, and health systems. Structural and functional alterations of vessels accumulate throughout life, culminating in increased risk of developing CVD. The growing elderly population worldwide highlights the need to understand how aging promotes CVD in order to develop new strategies to confront this challenge. This review provides examples of some major unresolved clinical problems encountered in daily cardiovascular practice as we care for elderly patients. Next, the authors summarize the current understanding of the mechanisms implicated in cardiovascular aging, and the potential for targeting novel pathways implicated in endothelial dysfunction, mitochondrial oxidative stress, chromatin remodeling, and genomic instability. Lastly, the authors consider critical aspects of vascular repair, including autologous transplantation of bone marrow-derived stem cells in elderly patients.
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Aging is associated with endothelial dysfunction and arterial stiffness and reduced autonomic reactivity, but vagal modulation of heart rate appears preserved.
“Even though aging is associated with endothelial dysfunction and arterial stiffness36 and reduced autonomic reactivity37, vagal modulation of the heart rate appears preserved38.”
From Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults (2021) · cites this paper as [36]
The ageing process results in decreases in the ejection fraction and the portion of cardiac output allocated to the brain, as well as the contraction of the cerebral vasculature, which jointly result in chronic brain hypoperfusion (CBH).
“However, the ageing process results in decreases in the ejection fraction and the portion of cardiac output allocated to the brain,203 as well as the contraction of the cerebral vasculature, which jointly result in chronic brain hypoperfusion (CBH).204,205”
From Antiageing strategy for neurodegenerative diseases: from mechanisms to clinical advances (2025) · cites this paper as [204]
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- Authors
- Paneni, F., Diaz Cañestro, C., Libby, P., Lüscher, T. F., & Camici, G. G.
- Affiliations
- University of Zurich (CH)
- Brigham and Women's Hospital (US)
- Corresponding author
- Camici, Giovanni G.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 69
- Issue
- 15
- Pages
- 1952-1967
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2606750738
- Cited by
- 618
- References
- 160
- Citations by year
- 2026: 54 · 2025: 96 · 2024: 61 · 2023: 61 · 2022: 74 · 2021: 73 · 2020: 65 · 2019: 57 · 2018: 50 · 2017: 26 · 2013: 1
- FWCI
- 7.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Funders
- National Science Foundation
- Amgen
- Pfizer
- AstraZeneca
- Sanofi
- Foundation for Cardiovascular Research
- Regeneron Pharmaceuticals
- Ionis Pharmaceuticals
- Kowa Company
- XBiotech
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Universität Zürich
- Esperion Therapeutics
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL080472)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Keywords
- cardiovascular aging, cardiovascular disease in older adults, endothelial dysfunction, mitochondrial oxidative stress, chromatin remodeling, genomic instability, vascular repair
- MeSH terms
- Aged, Aging, Cardiovascular Diseases, Cardiovascular System, Humans, Disease Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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