Age-related changes in vascular responses

Aging causes changes in the structure and function of the vessels that leads to an increase in the incidence of certain cardiovascular diseases, such as hypertension, coronary artery disease, heart failure. and postural hypotension with enhancement of both morbidity and mortality. When aging is associated xith hypertension. these changes are increased. Aging alters endothelial cells, and so the vascular tone regulation, reducing the endothelium-dependent relaxations, probably by a decrease in endothelial synthesis or release of nitric oxide. In addition, endothelium-independent relaxations are essentially unaltered, those elicited by beta-adrenoceptor agonists being usually reduced, Aging scarcely modifies the contractions induced by different agents, such as 5-hydroxytryptamine, histamine, high potassium, and angiotensin, whereas reduces those elicited by noradrenaline or endothelin. Vascular Ca2+ homeostasis appears to be altered in aging. The extracellular Ca2+ dependence of contractile responses elicited by agonists is enhanced, which explains the increased sensitivity to Ca2+ antagonists in elderly. Finally, Naf pump activity, that controls cellular ionic homeostasis, seems to be reduced in aging. The contractions elicited by Na+ pump inhibition with ouabain are negatively modulated by the release of a diffusible endothelial factor: an effect lost in aging, being replaced by an endothelium-dependent contracting factor that facilitates ouabain responses. (C) 1999 Elsevier Science Inc. All rights reserved.