1. Cardiovascular System
Aging & the
Cardiovascular System
Content for this module provided by The John A. Hartford Foundation, Institute for Geriatric Nursing, Online Gerontological Nursing Certification Review Course
Support for this project provided to School of Nursing, University of Washington by the John A. Hartford Foundation, Geriatric Nursing Education Grant and Nursing School Geriatric Investment Program Grant.

2. Normal Cardiovascular Changes
Normal Cardiovascular Changes
Difficult to differentiate between age-related changes and those related to an inactive lifestyle or disuse
Are the changes normal 'wear and tear' or cardiovascular disease?

3. Normal Heart Muscle Changes
Normal Heart Muscle Changes
Anatomical changes
Thickening of the left ventricular wall
 collagen,  elastin

4. Normal Heart Valve Changes
Normal Heart Valve Changes
Anatomical changes
 thickness
 flexibility
Aortic & mitral valve calcification
Mitral valve
Aortic valve

5. Normal SA Node & Intranodal Atrial Tract Changes
Normal SA Node & Intranodal Atrial Tract Changes
Anatomical changes
 # of pacemaker cells
Fibrous tissue infiltration of conductive system

6. Normal Artery Changes Anatomical changes
Normal Artery Changes
Anatomical changes
Peripheral arteries less resilient
Large arteries stiffer, less elastic,  elastin
Calcifications in artery walls, including aorta
Calcifications +  elastin +  collagen = stiffer vessels = more difficult to dilate

7. Normal Vein Changes Anatomical changes
Normal Vein Changes
Anatomical changes
Veins dilate & stretch with  elasticity
Intima & muscular walls thicken and become less elastic

8. Normal Coronary Artery Changes
Normal Coronary Artery Changes
Coronary artery blood flow  between ages 20 & 60
Effect:  oxygen delivery to the heart muscle, thus  ability to increase activity

9. Normal Changes: Aorta May become dilated, elongated, rigid
Normal Changes: Aorta
May become dilated, elongated, rigid
May develop calcifications and become tortuous
 elastin,  collagen = calcification
=  stiffness,  compliance

10. Normal Cardiovascular Physiologic Changes
Normal Cardiovascular Physiologic Changes
Summary - changes occur in:
heart rate
blood pressure
myocardial function
cardiac output
valvular function

11. Normal Cardiac Output Changes
Normal Cardiac Output Changes
Decreased cardiac output in response to exercise or stress
(effects are influenced by associated heart disease & level of baseline physical activity)

12. Normal Valvular Function Changes
Normal Valvular Function Changes
Systolic and diastolic murmurs may result from incomplete valve closures

13. Normal Myocardial Function Changes
Normal Myocardial Function Changes
 contractile strength & efficiency
 cardiac output
 cardiac reserve

14. Normal Heart Rate Changes
Normal Heart Rate Changes
 cardiac responsiveness rate with exercise
Heart may take longer to return to baseline rate

15. Normal SA Node & Intranodal Atrial Tract Changes
Normal SA Node & Intranodal Atrial Tract Changes
Physiological changes
Irritability of the myocardium may result in extra systoles, along with sinus arrhythmias & sinus bradycardia

16. Normal Blood Pressure Changes
Normal Blood Pressure Changes
Systolic blood pressure may rise disproportionately higher than diastolic

17. CV Links to Other Organs
CV Links to Other Organs
Changes in the cardiovascular system have direct effects on other organs
Example: atherosclerotic changes in blood vessels that occur in patients with hypertension may result in loss of renal function, vision impairment

18. Functional Implications of Normal Age-Related Changes*
Functional Implications of Normal Age-Related Changes*
 response to stress
Activity intolerance
Orthostatic hypotension
Dizziness w/position changes
*Influenced by presence of disease & lifestyle variations

19. Modifiable CV Risk Factors
Modifiable CV Risk Factors
Hypertension
Smoking
Dyslipidemia
low HDL
elevated LDL
elevated triglycerides
Diabetes mellitus
Physical inactivity
Obesity
Stress
Post-menopausal hormone therapy
Excess alcohol intake

20. Nursing Interventions
Nursing Interventions
Normal aging changes may be difficult to differentiate from changes r/t inactive lifestyle and/or CV disease

21. Nursing Interventions
Nursing Interventions
Education about cardiovascular risk factors, preventive measures & treatment regimens
Physical activity & smoking cessation are interventions that have impacts on CV health, as well as general health & healthy aging