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HES 383 > Cardiovascular Aging Pt. 1 > Flashcards

Cardiovascular Aging Pt. 1 Flashcards

1
Q

what is the role of the cardiovascular system

A

to transport blood throughout the body

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2
Q

which ventricle of the heart has a thicker wall

A

te left ventricle

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3
Q

why does the left ventricle have a thicker wall

A

it exerts more force to pump blood through our entire systemic circulation

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4
Q

what could occur if the left ventricle wall gets too thick

A

lose the efficiency of contraction, and lose the efficiency of how much blood can fill into the chamber of our left ventricle

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5
Q

what remains the leading cause of morbidity and mortality in most societies

A

cardiovascular diseases

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6
Q

what is the strongest independent risk factor of CVDs

A

aging

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7
Q

what are the accelerating risk factors of CVDs

A

metabolic disturbances like (insulin resistance, high blood lipids, and obesity), hypertension and smoking/alcohol

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8
Q

why does aging increase CVD risk

A

due to effects of aging on the heart and aging of the vasculature

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9
Q

what are the effects of aging on the heart

A

molecular and cellular changes lead to structural and functional changes

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10
Q

what are the effects of aging on the vasculature

A

molecular and cellular changes lead to structural and functional changes

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11
Q

what do the structural and functional changes in the heart and vessels increase the risk of

A
  1. fibrosis, left ventricular hypertrophy, systolic and diastolic dysfunction
  2. chronic high BP
  3. arrhythmias, myocardial infraction, heart failure, and stroke
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12
Q

what are the cellular mechanisms of cardiovascular aging and increased CVD risk

A
  • hypertension
  • coronary disease
  • stroke
  • kidney disease
  • cognitive impairment
  • Alzheimer’s disease
  • motor disorders, falls, exercise intolerence
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13
Q

whar are the normal effects of aging on the heart

A
  • cardiomyocytes senesence andincrease cell death
  • remaining functional myocyctes grow by hypertrophy
  • fibrosis
    -cellular aging
  • decreased sensitivity of response of sympathetic nervous system stimulation
  • structural and functional consequences
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14
Q

what is fibrosis in the heart

A

increased number of fibroblasta that cause collagen deposits

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15
Q

what are the structural and functional consequences of normal effects of aging on the heart

A
  • left side; ventricular hypertrophy and stiffening, atrial dilation
  • slowed electrical conduction
  • lower max heart rate
  • diastolic dysfuntion
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16
Q

what is diastolic dysfunction

A

impaired relaxation of the left ventricle that results in slower and delayed left ventricle filling

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17
Q

what are the age-related vascular dysfunctions

A
  1. stiffening, thickening, and dilation of the large elastic artieries
  2. endothelial dysfunction
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18
Q

what is endothelial dysfunction largely due to

A

increased oxidative stress and increased expression of pro-inflammatory cytokines that result in chronic inflammation

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19
Q

what causes stiffening of the arteries

A
  • elastin fibers degenerate
  • increased collagen deposits
  • protein cross-linking due to the formation of AGEs
  • Ca2+ deposit buildup in wall
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20
Q

what occurs when theres thickening of the arterial walls

A

hypertrophy of vascular smooth muscle cells, and some cells migrate from the media to the intima layer and an increase in collagen in the intima

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21
Q

what is dilation of the arteries due to

A

degeneration of elastin (walls have lost their elastic integrity)

22
Q

what happens to systolic blood pressure when major arteries become stiffer

A

systolic pressure will increase

23
Q

what does arterial stiffness result in

A

an increase of systolic pressure

24
Q

what are the effects of stiff arteries on pulse pressure

A

systolic pressure will increase, diastolic pressure will decrease, resulting in an increase of pulse pressure

25
Q

what is an ejection wave

A

moving the pulse forward

26
Q

what is a reflected wave

A

when a pusle moves backwords

27
Q

what is the augmentation pressure determined by

A

the size and timing of the reflected wave and is a reflection of arterial stiffness

28
Q

what does more stiff arteries equal to

A

higher augmentation

29
Q

what is pulse wave reflection

A

the timing of reflected wave back to the heart depends in stiffness of the artieres

30
Q

what is the relationship between younger artieres and the pulse wave reflection

A

younger arteries have more elastic that result in the reflected wave to be slow and reaches the heart during diastole

31
Q

what is the relationship between older artieres and the pulse wave reflection

A

older arteries are stiffer resulting in the reflected wave to get back to the heart sooner during systole

32
Q

what do stiffer arteries cause

A

a faster pulse wave

33
Q

what is the augmentation index and pusle wave velocity

A

measures that correlate with arterial stiffness

34
Q

how do you calculate pusle wave velocity

A

distnce/time

35
Q

what is vascular endothelial dysfunction caused by

A

1) oxidatice stress which then increased expression of inflammatory mediators in the endothelial cells
2) excess production of ROS
3) decreased endothelial Nitric oxide (NO)

36
Q

what is the result of when endothelial cells secrete endothelial nitric oxide

A

increase in vasodilation endothelin 1 causing vasoconstriction

37
Q

what is reduced vasodilation in aging blood vessels due to

A

endothelial dysfunction

38
Q

Ach stimulates the production of what

A

nitric oxide

39
Q

when does the decline in endothelia function begin

A

around the 4th decade of life

40
Q

when does the decline in endothelia function begin for women

A

around the 5th decade of life due to menopause

41
Q

the rate of decline of endothelial function is greater in what sex with aging

A

greater in women than men

42
Q

what happens to systolic blood pressure when arteries lose ability to vasodilate

A

systolic pressure will increase

43
Q

what is mean arterial pressure governed by

A

cardiac output and the peripheral resistance modulated at the arterioles

44
Q

what changes in blood pressure as a result of age-related vascular dysfunction

A

impaired nitric oxide response and stiffening of the large elastic arteries

45
Q

what occurs during the impaired nitric oxide response

A

increased peripheral resistance that results in increased systolic pressure and diastolic pressure

46
Q

what occurs during the stiffening of the large elastic arteries

A

an increae in systolic pressure and a decrease in diastolic pressure

47
Q

how does tracking blood pressure with age happen

A

progressive increae in systolic blood pressure with age and an increase then decrease in diastolic blood pressure with age

48
Q

what is progressive increae in systolic blood pressure with age due to

A

endothelial dysfunction and aortic stiffening

49
Q

what happens to the left ventricle when there is an increased systolic pressure due to stiffer aorta

A

the left ventricle needs to work harder to eject blood and an increased afterload results in left ventricular hypertrophy

50
Q

what are the effects of continued pressure overload on the heart

A

higher oxyegn demands on the heart and abnormal cardiac cycle

51
Q

what are the peripheral consequences of increased systolic pressure

A

high pulse pressure that can damage fragile capillary beds, leading to microvascular disease

52
Q

which organs are most at risk from high systolic pressure and why

A

1) kidney and brain due to their high resting blood flow
2) pulse-wave nephropathy resulting in kideny impairment, chronic kidney disease/failure
3) pulse-wave encephalopathy resulting in mircovascular brain damage, increased stroke risk and cognitive impairment/dementia

HES 383 (14 decks)

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