Cited by 618Cardiovascular Health and Disease PreventionNitric Oxide and Endothelin EffectsAtherosclerosis and Cardiovascular Diseases

The Aging Cardiovascular System

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Paneni, Francesco, Diaz Cañestro, Candela, Libby, Peter, Lüscher, Thomas F., Camici, Giovanni G.·2017·Journal of the American College of Cardiology

Abstract

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.”
  • 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”

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Research works printed but not linked: 3

  1. Ungvari Z, Orosz Z, Labinskyy N, et al. Increased mitochondrial H2O2 production pro- motes endothelial NF-kB activation in aged rat arteries. Am J Physiol Heart Circ Physiol 2007;293: H37-47.
  2. Francia P, delli Gatti C, Bachschmid M, et al. Deletion of p66shc gene protects against age- related endothelial dysfunction. Circulation 2004;110:2889-95.
  3. Pagnin E, Fadini G, de Toni R, et al. Diabetes induces p66shc gene expression in human pe- ripheral blood mononuclear cells: relationship to oxidative stress. J Clin Endocrinol Metab 2005;90: 1130-6.

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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
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

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