Circulatory System

Blood Formed Elements erythrocytes - hemoglobin leukocytes - immune function platelets - clotting Plasma water salts (electrolytes) nutrients wastes proteins albumins, immunoglobulins, fibrinogen

Lymphatic System

Age Related Changes - Blood 1. Few Changes all parameters fairly stable fibrinogen increases with age (25% by age 70) small increase in viscosity decrease in red bone marrow (decline in reserve capacity)

Age Related Changes (Heart) Structural 1. Loss of muscle cells replaced with connective tissue 2. Accumulation of lipofuscin (up to 7% of volume) 3. Endocardium thickens, valves thicken and harden, calcify Functional - Little Change in Healthy Inds. At Rest 1. Decrease in Cardiac Reserve (capacity to exercise) 2. Increase in Blood Pressure

Age Related Changes (Vessels) 1. Decrease Elasticity of Vessels (arteriosclerosis) decrease elastin, increase collagen, increase crossbridges 2. Thickening of Arterial Walls 3. Decrease in lumen volume 4. Increase in peripheral resistance hypertrophy of left ventricle

Age Related Pathologies Atherosclerosis- normal or pathological ? Multifactorial disease Age-related changes vs. Environ. Factors Endothelial Damage - platelet involvement Macrophage infiltration - “foam cells” Increase Cell Proliferation (intima) - atheroma Deposition of Lipids - dependent on serum lipids LDL vs. HDL Calcification

Atherosclerosis

Fibrous Plaque

Myocardial Infarction

Risk Factors 1. High blood cholesterol (especially LDL or "bad" cholesterol over 100 mg/dL) 2. Cigarette smoking and exposure to tobacco smoke 3. High blood pressure 4. Diabetes mellitus 5. Obesity 6. Physical inactivity

Hypertension Elevation of Blood Pressure with Age Systolic/Diastolic e.g. 140/90 Result of Arteriosclerosis/ Atherosclerosis Leads to kidney Damage Increase risk for stroke, aneurysm, CHD

Coronary Artery Disease Insufficient blood flow to cardiac muscle Ischemic Heart Disease Angina Thrombus Myocardial Infarction

Congestive Heart Failure Cardiac Insufficiency - heart too weak to pump enough blood (decrease in cardiac output) Blood pressure drops Blood pools in veins Kidney function adversely affected If left ventricle most affected, blood pools on pulmonary side leading to pulmonary edema