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HES 383 > Cardiovascular Aging Pt. 2 > Flashcards

Cardiovascular Aging Pt. 2 Flashcards

1
Q

what causes degeneration of elastin and increased collagen in arteries

A

aging, which leads to changes like crosslinking and Ca2+ buildup

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2
Q

what happens to systolic and diastolic pressure with age

A

systolic pressure increases and diastolic pressure decreases due to arterial stiffening

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3
Q

what is the effect of endothelial dysfunction of blood pressure

A

causes vasoconstriction, increased peripheral resistance, and increased systolic pressure

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4
Q

how much does systolic pressure increase from 20-80 YO

A

~30mmHg

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5
Q

~80% of the population have _______ by 80 YO

A

have isolated systolic hypertension

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6
Q

what does aortic impedance represent

A

left ventricular afterload

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7
Q

what is left ventricular afterload

A

the force needed from the LV in order to eject blood into the aorta

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8
Q

what does increased and earlier wave reflection contribute to

A

aortic pressure during systolic and affects coronary perfusion

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9
Q

wear and tear of the arteries is a result from

A

fracture of aortic elastic lamellae

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10
Q

how is a pulse wave generated

A

by each ejection of stroke volume from the left ventricle

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11
Q

what is a pulse wave reflection

A

when a pulse hits a branching point in the arteries and bounces back toward the heart

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12
Q

what happens to a pulse wave when is hits a bifurcation point

A

a reflected wave is generated and returns back to the heart

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13
Q

what affects the timing and velocity of the reflected wave

A

depend on the stiffness of the large elastic arteries

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14
Q

what is the augmentation pressure determined by

A

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

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15
Q

what happens to the reflected wave in younger more elastic arteries

A

the reflected wave is slow and reaches the heart during diastole

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16
Q

what happens to reflected wave in older more stiff arteries

A

the reflected wave gets back to the heart sooner during systole

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17
Q

when does the blood enter the coronary arteries occur

A

during the diastolic phase of the cardiac cycle

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18
Q

what does early wave reflection result in

A

less contribution to coronary circulation during diastole

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19
Q

what does the heart do to pump into stiffened arteries

A

it maintains a higher force of contraction

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20
Q

what happens due to more forceful ejection in stiffened arteries

A

a pulse pressure that extends into the microvasculature

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21
Q

what is the risk of fragile capillaries due to high pulse pressure

A

higher risk of thrombosis and rupture

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22
Q

what happens to augmentation and pulse pressure in stiff large arteries

A

they both increase

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23
Q

how does pulse travel through stiff large arteries

A

travels faster, and is measured as pulse wave velocity (PWV)

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24
Q

what is PWV related to

A

the intrinsic elasticity of the arterial wall

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25
Q

where does earlier wave reflection occur

A

in stiff large arteries

26
Q

what is high plasticity in the cerebral microcirculation associated with

A

changes in the brain commonly seen in Alzheimer’s disease and other types of dementia

27
Q

what are cardiac consequences of increased systolic blood pressure

A
  • Increased left ventricular afterload
  • higher force
  • greater force required and larger muscle mass means higher metabolic demands of the heart
  • coronary perfusion
28
Q

what are the results of cardiac metabolic demand exceeds blood supply

A

myocardial ischemia

29
Q

what is coronary perfusion during diastole

A

when blood flows into the coronary arteries

30
Q

what are the consequences of aging on coronary perfusion

A
  • shorter duration of diastole
  • decreased diastole blood pressure
  • early wave reflection
31
Q

what is shorter duration of diastole due to and result in

A

LV hypertrophy and slower rates of LV relaxation resulting in less time for blood to flow into coronary circulation

32
Q

what is myocardial ischemia

A

insufficient blood flow to meet metabolic demands of the left ventricle

33
Q

what are the consequences of myocardial ischemia

A

angina pectoris and arrhythmias

34
Q

what is angina pectoris

A

chest pain due to myocardial ischemia

35
Q

what is arrhythmias

A

heart rhythm disturbances

36
Q

what is myocardial ischemia arrhythmias due to

A

metabolite build up and increased fibrosis within the myocardium

37
Q

what does myocardial ischemia lead to

A

build up of metabolites in the coronary bloodstream

38
Q

what occurs overtime due to myocardial ischemia

A

the overworked and under oxygenated heart muscle fatigues increasing the risk of heart failure and congestive heart failure (CHF)

39
Q

what are the mechanisms of pathological ventricular remodeling

A

1) cardiomyocyte loss, cardiomyocyte hypertrophy, and fibrosis
2) lead to ischemic phenotypes and hypertrophic phenotypes
3) results in heart failure

40
Q

what is heart failure

A

when the ventricle has weakened and can no longer maintain the cardiac output required

41
Q

what is the cause of heart failure

A
  • coronary artery disease
  • chronic uncontrolled high systolic blood pressure
  • arrythmias or heart attack that has weakened the heart muscle
42
Q

what is a congestive heart failure

A

blood back up that results in fluid to be forced out of capillaries and into surrounding tissues

43
Q

what are the mechanisms that atherosclerosis accelerates the progression of CVD

A

1) plaque formation
2) Inflammation
3) increased blood pressure
4) reduced oxygen supply
5) endothelial dysfunction

44
Q

what is plaque formation regarding atherosclerosis and the progression of CVD

A

build up of fatty deposits that narrow the arteries, reducing blood flow to the heart

45
Q

what is inflammation regarding atherosclerosis and the progression of CVD

A

the plaques cause chronic inflammation which can weaken the arterial walls and make them more prone to rupture

46
Q

what is increased blood pressure regarding atherosclerosis and the progression of CVD

A

narrowed arteries force the heart to pump harder to push blood through

47
Q

what is reduced oxygen supply regarding atherosclerosis and the progression of CVD

A

when plaques can block blood flow, reducing the oxygen supply to the heart muscle

48
Q

what is endothelial dysfunction regarding atherosclerosis and the progression of CVD

A

atherosclerosis damages the endothelium impairs its ability to regulate blood flow and clotting

49
Q

what are the effects of aging on blood pressure regulation

A

central control of blood pressure by the baroreceptor reflex

50
Q

what are baroreceptors located in

A

in the walls of the carotid artery and aortic arch

51
Q

what do baroreceptors respond to

A

increased BP by increasing firing rate

52
Q

where does the baroreceptor reflex signal to

A

the cardiovascular control center in the medulla

53
Q

what is the baroreceptor reflex response

A

to restore BP

54
Q

what are the effects of aging on BP regulation impaired by

A
  • stiffer blood vessels
  • decreased baroreceptor sensitivity to stretch
  • decreased SNS response of heart and vasculature
55
Q

what does aging and systolic BP elevation cause

A

impaired BP regulation that results in acute hypotension then cerebral hypoperfusion

56
Q

what are symptoms of BP regulation

A

light-headedness, dizziness, blurred vision, weakness, nausea, and feeling faint

57
Q

what are the consequences of BP regulation

A

syncope, falls, and long term cognitive dysfunction, increased morbidity, and mortality

58
Q

what is orthostatic hypotension

A

a drop of BP of at least 20 mmHg (systolic) and/or at least 10mmHg (diastolic) when moving from a supine position to upright within 3 minutes of standing

59
Q

what is orthostatic hypotension due to

A

an impaired BP response to the drop in venous return that normally occurs on assuming an upright position

60
Q

~ 30% of adults greater than 70 YO experience what

A

orthostatic hypotension

61
Q

what is the treatment for orthostatic hypotension

A

maintain a healthy water intake, healthy salt intake, compressions stockings, and slight inclined position while sleeping

HES 383 (14 decks)

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