- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Chapter 95 Cardiac and vascular ageing
- Chapter 96 Dyslipidemias and other cardiometabolic risk factors in older adults
- Chapter 97 Physical factors in arterial ageing
- Chapter 98 Peripheral vascular disease in older adults: diagnostic and treatment considerations
- Chapter 99 Aneurysmal diseases
- Chapter 100 Pulmonary thromboembolism
- Chapter 101 Hypertension in older adults
- Chapter 102 Syncope and neurocardiovascular instability
- Chapter 103 Management of atrial fibrillation and anticoagulant therapies
- Chapter 104 Management of bradyarrhythmias
- Chapter 105 Management of tachyarrhythmias
- Chapter 106 Ischaemic heart disease
- Chapter 107 Valvular heart disease: state of the art and treatment perspectives
- Chapter 108 Heart failure: definitions, investigation, and management
- Chapter 109 Cardiac rehabilitation
- Chapter 110 Cardiopulmonary resuscitation: outcomes and decision-making processes for older adults
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing
(p. 743) Physical factors in arterial ageing
- Chapter:
- (p. 743) Physical factors in arterial ageing
- Author(s):
Junichiro Hashimoto
and Michael F. O’Rourke
- DOI:
- 10.1093/med/9780198701590.003.0097
Arterial structure and function change progressively with advancing age. Owing to long-lasting repetitive stretch with intermittent cardiac contraction, elastic fibres in the tunica media of large arteries progressively degenerate and are replaced by collagenous fibres. Such degeneration causes elastic arteries to stiffen and dilate. Stiffening of the large arteries not only increases amplitude of the incident pressure wave but also hastens the return of the reflected pressure wave, thereby widening the pulse pressure in the central aorta. This widening increases the cardiac afterload during systole, while it decreases coronary flow during diastole, thus predisposing to heart failure and coronary ischaemia. Also, the excessive pulsatile pressure is transmitted deeply into the renal and cerebral microvasculature causing microalbuminuria and lacunar infarction. Although arterial ageing is considered an inevitable and irreversible process, it can be delayed through optimal blood pressure control.
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- Section 1 Ageing population and policy
- Section 2 Key concepts in care of older adults
- Section 3 Principles and organization of care
- Section 4 Age-related biological changes, altered physiology, and vulnerability to diseases and chronic conditions
- Section 5 Geriatric syndromes in clinical practice
- Section 6 Nutrition and metabolism
- Section 7 Mobility disorders: prevention, impact, and compensation
- Section 8 Infections in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 9 Cancer: epidemiology, pathophysiology, diagnosis, and management
- Section 10 Vascular diseases: epidemiology, pathophysiology, diagnosis, and management
- Chapter 95 Cardiac and vascular ageing
- Chapter 96 Dyslipidemias and other cardiometabolic risk factors in older adults
- Chapter 97 Physical factors in arterial ageing
- Chapter 98 Peripheral vascular disease in older adults: diagnostic and treatment considerations
- Chapter 99 Aneurysmal diseases
- Chapter 100 Pulmonary thromboembolism
- Chapter 101 Hypertension in older adults
- Chapter 102 Syncope and neurocardiovascular instability
- Chapter 103 Management of atrial fibrillation and anticoagulant therapies
- Chapter 104 Management of bradyarrhythmias
- Chapter 105 Management of tachyarrhythmias
- Chapter 106 Ischaemic heart disease
- Chapter 107 Valvular heart disease: state of the art and treatment perspectives
- Chapter 108 Heart failure: definitions, investigation, and management
- Chapter 109 Cardiac rehabilitation
- Chapter 110 Cardiopulmonary resuscitation: outcomes and decision-making processes for older adults
- Section 11 Neurological disorders: epidemiology, pathophysiology, diagnosis, and management
- Section 12 Cognitive decline and dementia in older adults: epidemiology, pathophysiology, diagnosis, and management
- Section 13 Mental health of older adults
- Section 14 Management of common medical conditions: epidemiology, pathophysiology, diagnosis, and management
- Section 15 Palliative medicine and end-of-life care
- Section 16 Healthy ageing