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(Circulation. 2003;107:139.)
© 2003 American Heart Association, Inc.

Special Review: Clinical Cardiology: New Frontiers

Arterial and Cardiac Aging: Major Shareholders in Cardiovascular Disease Enterprises

Part I: Aging Arteries: A "Set Up" for Vascular Disease

Edward G. Lakatta, MD; Daniel Levy, MD

From the Gerontology Research Center, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Md; and the Framingham Heart Study, National Heart, Lung and Blood Institute, National Institutes of Health, Framingham, Mass.

Correspondence to Edward G. Lakatta, MD, National Institute on Aging, Intramural Research Program, Gerontology Research Center, Laboratory of Cardiovascular Science, 5600 Nathan Shock Dr, Baltimore, MD 21224-6825. E-mail lakattae@grc.nia.nih.gov

Key Words: aging • cardiovascular disease • epidemiology • remodeling • risk factors

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The Demographic Imperative and the Risk of Vascular Diseases in Older Persons

Our population is aging; in the United States today there are 35 million people 65 years of age or older. That number will double by the year 2030 (Figure 1). Although epidemiological studies have discovered that lipid levels, diabetes, sedentary lifestyle, and genetic factors are risk factors for coronary disease, hypertension, congestive heart failure, and stroke, the quintessential cardiovascular diseases within our society, advancing age unequivocally confers the major risk. The incidence and prevalence of these diseases increase steeply with advancing age (Figure 2). Not only does clinically overt cardiovascular disease increase dramatically with aging, but so do subclinical or occult diseases, such as silent coronary atherosclerosis. Figure 3 (top) shows that a substantial percentage of older, community-dwelling, otherwise healthy volunteers have evidence of inducible ischemia during combined thallium/ECG treadmill stress testing, and their prognosis is poor compared with their counterparts without subclinical coronary disease (Figure 3, bottom).

View larger version (22K): [in this window] [in a new window]   Figure 1. The demographic imperative. Numbers of persons 65 years of age or older (light bars) and 85 years of age or older in the United States from 1900 through 2030. Data taken from the US Census Bureau data with projections for 2030.

View larger version (27K): [in this window] [in a new window]   Figure 2. A, Prevalence of hypertension, defined as systolic blood pressure 140, diastolic blood pressure 90, or current use of medication for purposes of treating high blood pressure. Data are based on National Health and Nutrition Examination Survey III (1988–1991) (Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the . . . [Full Text of this Article]

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				K. L. Moreau, K. M. Gavin, A. E. Plum, and D. R. Seals Ascorbic Acid Selectively Improves Large Elastic Artery Compliance in Postmenopausal Women Hypertension, June 1, 2005; 45(6): 1107 - 1112. [Abstract] [Full Text] [PDF]

				D. S. DeLorey, J. M. Kowalchuk, and D. H. Paterson Adaptation of pulmonary O2 uptake kinetics and muscle deoxygenation at the onset of heavy-intensity exercise in young and older adults J Appl Physiol, May 1, 2005; 98(5): 1697 - 1704. [Abstract] [Full Text] [PDF]

				D. M. Sengstock, P. V. Vaitkevicius, and M. A. Supiano Arterial Stiffness Is Related to Insulin Resistance in Nondiabetic Hypertensive Older Adults J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 2823 - 2827. [Abstract] [Full Text] [PDF]

				S. J. Zieman, V. Melenovsky, and D. A. Kass Mechanisms, Pathophysiology, and Therapy of Arterial Stiffness Arterioscler Thromb Vasc Biol, May 1, 2005; 25(5): 932 - 943. [Abstract] [Full Text] [PDF]

				S. Pepe and E. G. Lakatta Aging hearts and vessels: Masters of adaptation and survival Cardiovasc Res, May 1, 2005; 66(2): 190 - 193. [Full Text] [PDF]

				A. J. Donato, L. A. Lesniewski, and M. D. Delp The effects of aging and exercise training on endothelin-1 vasoconstrictor responses in rat skeletal muscle arterioles Cardiovasc Res, May 1, 2005; 66(2): 393 - 401. [Abstract] [Full Text] [PDF]

				M. L. Lindsey, D. K. Goshorn, C. E. Squires, G. P. Escobar, J. W. Hendrick, J. T. Mingoia, S. E. Sweterlitsch, and F. G. Spinale Age-dependent changes in myocardial matrix metalloproteinase/tissue inhibitor of metalloproteinase profiles and fibroblast function Cardiovasc Res, May 1, 2005; 66(2): 410 - 419. [Abstract] [Full Text] [PDF]

				O. W.H. van der Heijden, Y. P.G. Essers, G. Fazzi, L. L.H. Peeters, J. G.R. De Mey, and G. J.J.M. van Eys Uterine Artery Remodeling and Reproductive Performance Are Impaired in Endothelial Nitric Oxide Synthase-Deficient Mice Biol Reprod, May 1, 2005; 72(5): 1161 - 1168. [Abstract] [Full Text] [PDF]

				M. F. O'Rourke and W. W. Nichols Aortic Diameter, Aortic Stiffness, and Wave Reflection Increase With Age and Isolated Systolic Hypertension Hypertension, April 1, 2005; 45(4): 652 - 658. [Full Text] [PDF]

				D. O. Debrah, K. P. Conrad, L. A. Danielson, and S. G. Shroff Effects of relaxin on systemic arterial hemodynamics and mechanical properties in conscious rats: sex dependency and dose response J Appl Physiol, March 1, 2005; 98(3): 1013 - 1020. [Abstract] [Full Text] [PDF]

				D. C. Haas, G. L. Foster, F. J. Nieto, S. Redline, H. E. Resnick, J. A. Robbins, T. Young, and T. G. Pickering Age-Dependent Associations Between Sleep-Disordered Breathing and Hypertension: Importance of Discriminating Between Systolic/Diastolic Hypertension and Isolated Systolic Hypertension in the Sleep Heart Health Study Circulation, February 8, 2005; 111(5): 614 - 621. [Abstract] [Full Text] [PDF]

				D. R. Seals and P. E. Gates Stiffening Our Resolve Against Adult Weight Gain Hypertension, February 1, 2005; 45(2): 175 - 177. [Full Text] [PDF]

				K. Park, J. W. Shin, J. K. Oh, K. S. Ryu, S. W. Kim, and J.-S. Paick Restoration of Erectile Capacity in Normotensive Aged Rats by Modulation of Angiotensin Receptor Type 1 J Androl, January 1, 2005; 26(1): 123 - 128. [Abstract] [Full Text] [PDF]

				K. A. Blackwell, J. P. Sorenson, D. M. Richardson, L. A. Smith, O. Suda, K. Nath, and Z. S. Katusic Mechanisms of aging-induced impairment of endothelium-dependent relaxation: role of tetrahydrobiopterin Am J Physiol Heart Circ Physiol, December 1, 2004; 287(6): H2448 - H2453. [Abstract] [Full Text] [PDF]

				D. Torella, D. Leosco, C. Indolfi, A. Curcio, C. Coppola, G. M. Ellison, V. G. Russo, M. Torella, G. L. Volti, F. Rengo, et al. Aging exacerbates negative remodeling and impairs endothelial regeneration after balloon injury Am J Physiol Heart Circ Physiol, December 1, 2004; 287(6): H2850 - H2860. [Abstract] [Full Text] [PDF]

				A. Arbab-Zadeh, E. Dijk, A. Prasad, Q. Fu, P. Torres, R. Zhang, J. D. Thomas, D. Palmer, and B. D. Levine Effect of Aging and Physical Activity on Left Ventricular Compliance Circulation, September 28, 2004; 110(13): 1799 - 1805. [Abstract] [Full Text] [PDF]