Aging and the Vasculature

Question 1

Werner’s Syndrome

• problem
• onset
• death
• symptoms
• cause

Answer 1

Werner’s Syndrome

• DNA helicase –> bad DNA repair and replication
• onset in 20s
• death in 40s
• atherosclerosis, arthritis, old phenotype
• AUTOSOMAL RECESSIVE

Question 2

Hutchinson-Gilford Progeria Syndrome (HGPS)

• problem
• onset
• death
• symptoms
• cause

Answer 2

Hutchinson-Gilford Progeria Syndrome (HGPS)

• nuclear lamin –> bad DNA replication + repair
• onset at infancy
• death at 13
• look normal at birth, age quickly
• unknown cause

Question 3

what drugs do you give patients for hypotension?

Answer 3

things that decrease the workload of the heart: 
diuretics
ACE inhibitors
ARB
Ca channel blockers
Beta Blockers

Question 4

what are the barriers to BP control in the elderly?

Answer 4

cost
patients may be asymptomatic
increasing prevalence of comorbidities

Question 5

Most disease have increased prevalence in the elderly. Which disease do not?

Answer 5

PAD = peripheral artery disease

Diabetes

Question 6

what over the counter drugs may have drug-drug interactions with hypotension drugs?

Answer 6

patients may take NSAIDs to monitor their pain. Hyperkalemia may occur when NSAIDs are given in combination with:
ACE inhibitors
ARBs
aldosterone/renin inhibitors

hyperkalemia –> heart arrhythmias

Question 7

the FBF test shows what in elderly?

Answer 7

FBF –> release ACh –> see vasodilation
elderly patients have blunted endothelial-dependent vasodilation.

This can be improved after exercise training.

Question 8

what does the FMD test show?

Answer 8

FBD = flow mediated dilation
reactive hyperemia
diet –> weight loss and reduced salt intake increases FMD