Cardiovascular aging in health

Major focuses of geriatric medicine are cardiovascular diseases with increases in prevalence in older people and how aging might modify the risk factors, clinical manifestations, treatment strategies, and prognoses of these diseases. Quantitative information on age-associated alterations in cardiovascular structure and function in health is essential to define and target the specific characteristics of the cardiovascular aging process that render it the major risk factor for cardiovascular diseases. Such information also is required to differentiate among the limitations of elderly individuals that relate to disease and limitations that may fall within expected normal limits. Differences in cardiovascular function between older and younger individuals have been described extensively in the literature, but confusion often arises in the interpretation of these differences because of a failure to acknowledge or to control for interactions among age, disease, and lifestyle. The Baltimore Longitudinal Study on Aging has made an effort to characterize the effects of aging on multiple aspects of cardiovascular structure and function. The concepts that have evolved from this and other studies are discussed.