GERONTOLOGIC CONDITIONS: .
Greatest risk for Cardiovascular Disease is age; many of the physiologic changes in cardiovascular system of older adults are result of combined effects of aging process, disease, environmental factors, lifetime health behaviors.
- Major changes in cardiovascular system: response to physical or emotional stress: blunted HR. response to changes in position.
- Age related changes:
- collage in heart increases, elastin decreases (affecting stretch ability and reducing cardiac reserve)
o cardiac valves are thicker b/c lipid accumulation, valve calicification, degeneration of collagen and fibrosis affecting aortic and mintral valves-> regurgitation of vlood or narrowing of the valve orifice (stenosis) when it should be open -> “murmur”: turbulent blood flow across affected heart.
o SA node pacemaker cells decrease, may account for frequecey of sinus dysrhythmias in older adults).
o Cellular aging and fibrosis of conduction system: decreased amplitude of QRS comples, irregular cardiac rhythms, decreased maximal HR and variability.
o Beta adrenergic receptors decrease-> decreased response to physical and emotional stress, less sensitive to beta adrenergic agonist drugs.
o Lower max HR. results in only a two fold increase in CO (less blood for tissues).
o BVs less elastic, increase sensitivity to vasopressin (antidiuretic)-> progressive increase in SBP and decrease/no change in Diastolic-> increased Pulse Pressure.
o *Hypertension is NOT normal for aging; orthostatic hypertension may be related to meds or decreased baroreceptor function.
o Kyphosis: Altered chest landmarks for palpation, percussion, and auscultation. Distant heart sounds.
o Arterial stifferening due to loss of elastin, progressive fibrosis: increased systolic BP, possible widened pulse pressure, pedal pulses diminished, increased intermittent claudication.
o Decreased CO, HR., SV in response to exercise or stress: decreased response to exercise and stress; slowed recovery from activity