YAŞLANMA VE KARDIYOVASKÜLER HASTALIKLAR

Abstract

Dünya Sağlık Örgütü’ne göre yaşlı terimi; 65 yaşın üstündeki kişiler için ifade edilmektedir. Yaşlanmayla birlikte kalp atım hacminde, kalp işlevinde, oksijenin tüketiminde ve atım sayısında düşmeler meydana gelmektedir. Yaşlanma ile birlikte kardiyovasküler sistemde birçok değişiklik meydana gelmekte ve bu durum hastalıklara zemin hazırlamaktadır. Bu derleme makale de yaşlanma ve kardiyovasküler hastalıklar arasındaki fizyolojik ilişkiye değinmek amaçlanmıştır. Genetik zemindeki farklılıklara ve yaşa bağlı olarak kalbin kan pompalama becerisi düşer, miyokard esnekliğini kaybeder, kalp kapaklarının çapında kalınlaşma ve artma meydana gelir. Yaşlanma yaşamın kaçınılmaz bir bölümüdür ve kardiyovasküler hastalıklar için en önemli risk faktörünü oluşturmaktadır. Arterioskleroza bağlı olarak kan damarlarının kalınlığı artarken elastikiyeti düşer. Yaşlılıkta kardiyovasküler sistemdeki işlevsel ve yapısal değişimler koroner arter hastalığı, kalp hastalıkları, kalp yetmezliği, venöz tromboz ve hipertansiyon görülme riskini artırmaktadır. Yaşlanma ile kardiyak debi ve stroke volüme düşüp, postural hipotansiyon riski yükselmektedir. İlerleyen yaşla damarların sertleşip elastikiyetinin düşmesi sonucu sistolik kan basıncında sürekli bir yükseliş meydana gelir. 60 ve sonrasında diyastolik kan basıncında ise ya hafifçe bir düşme görülür ya da değişiklik görülmez.

Keywords

• Yaşlanma
• kardiyovasküler hastalıklar
• kronik hastalıklar

AGING AND CARDIOVASCULAR DISEASES

Abstract

According to the World Health Organization, the term “elderly” refers to people over the age of 65. Decreases in heart rate, heart function, oxygen consumption and stroke rate occur with aging. Many changes occur in the cardiovascular system with aging, and this predisposes to diseases. The aim of this review article is to examine the physiological relationship between aging and cardiovascular diseases. Depending on genetic differences and age, the heart's ability to pump blood decreases, the myocardium loses flexibility, and the heart valves thicken and increase in diameter. Aging is an inevitable part of life and constitutes the most important risk factor for cardiovascular diseases. Arteriosclerosis increases the thickness of blood vessels while decreasing their elasticity. Functional and structural changes in the cardiovascular system in older ages increase the risk of coronary artery disease, heart diseases, heart failure, venous thrombosis, and hypertension. Cardiac output and stroke volume decreases and the risk of postural hypotension increases. With advancing age, a continuous rise in systolic blood pressure occurs as a result of a hardening of the vessels and their diminished elasticity. After the age of 60, either a slight decrease or no change is seen in diastolic blood pressure.

Keywords

• Aging
• cardiovascular diseases
• chronic diseases.

References

1. Özütürker M. The effect of postmodernism on old life and the problems of the elderly. EÜSBED. 2022;15(2):148-167. doi:10.46790.erzisosbil.1123 434.
2. Lettino M, Mascherbauer J, Nordaby M, et al. Cardiovascular disease in the elderly: Proceedings of the European Society of Cardiology-Cardiovascular Round Table. Eur J Prev Cardiol. 2022;29(10):1412-1424. doi:10.1093/eurjpc/zwac033.
3. Avesta L, Rasoolzadeh S, Naeim M, Kamran A. Prevalence of cardiovascular disease risk factors in the women population covered by health centers in ardabil. Int J Hypertens. 2022:2843249. doi:10.11 55/2022/2843249.
4. Guo J, Huang X, Dou L, et al. Aging and aging-related diseases: From molecular mechanisms to interventions and treatments. Signal Transduct Target Ther. 2022;7(1):391. doi:10.1038/s41392-022-01251-0.
5. Steppan J, Nyhan D, Santhanam L. Editorial: Cardiovascular remodeling in aging and disease. Front Physiol. 2022;13:867185. doi:10.3389/fphys.2022. 867185.
6. Jayawardhana T, Jayathilaka R, Nimnadi T, et al. The cost of aging: Economic growth perspectives for Europe. PLoS One. 2023;18(6):e0287207. doi:10.13 71/journal.pone.0287207.
7. WHO. Ageing and health, 2023. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health#:~:text=The%20UN%20Decade%20of%20Healthy%20Ageing Published October 1, 2024. Accessed October 03, 2024.
8. Green S, Hillersdal L. Aging biomarkers and the measurement of health and risk. HPLS. 2021;43:28. doi:10.1007/s40656-021-00367-w

9. Kashtanova DA, Taraskina AN, Erema VV, et al. Analyzing successful aging and longevity: Risk factors and health promoters in 2020 older adults. Int J Environ Res Public Health. 2022;19(13):8178. doi:10.3390/ijerph19138178
10. Gupta R, Sharma M, Goyal NK, Bansal P, Lodha S, Sharma KK. Gender differences in 7 years trends in cholesterol lipoproteins and lipids in India: Insights from a hospital database. Indian J Endocrinol Metab. 2016;20(2):211-218. doi:10.4103/2230-8210.176 362. 
11. Cla T. Time to tackle the physical activity gender gap. The Lancet Public Health. 2019;6:e1077-1086. doi:10.1016/S2468-2667(19)30135-5
12. Baum F, Musolino C, Gesesew HA, Popay J. New perspective on why women live longer than men: An exploration of power, gender, social determinants, and capitals. Int J Environ Res Public Health. 2021;18(2):661. doi:10.3390/ijerph18020661.
13. Browning C, Ory MG, Pei X. Editorial: Women in science: Aging and public health 2021. Front Public Health. 2022;10:895113. doi:10.3389/fpubh.2023. 1226240.
14. Preston J, Biddell B. The physiology of ageing and how these changes affect older people. Medicine. 2021;49(1):1-5. doi:10.1016/j.mpme d.2020.10.011
15. Seidu S, Khunti K, Yates T, Almaqhawi A, Davies MJ, Sargeant J. The importance of physical activity in management of type 2 diabetes and COVID-19. Ther Adv Endocrinol Metab. 2021;12. doi:10.1177/2042 0188211054686
16. Blain H, Masud T, Dargent-Molina P, et al. A comprehensive fracture prevention strategy in older adults: The European Union Geriatric Medicine Society (EUGMS) statement. J Nutr Health Aging. 2016;20(6):647-652. doi:10.1007/s40520-016-0588-4
17. Mehdizadeh M, Aguilar M, Thorin E, Ferbeyre G, Nattel S. The role of cellular senescence in cardiac disease: Basic biology and clinical relevance. Nat Rev Cardiol. 2022;19(4):250-264. doi:10.1038/s41 569-021-00624-2
18. Pires Da Silva J, Padilla PA, Garcia AM. Editorial: The intersection of gene regulation and metabolism in cardiovascular disease. Front Genet. 2023;14:12536 90. doi:10.3389/fgene.2023.12536 90.
19. Özer HH, Baksi A, Uslusoy E. Examining the relationship of nursing students’ attitudes towards elderly individuals and their levels of compassion with the factors influential on them. IJHSRP. 2023;8(3):183-197. doi:10.33457/ijhsrp.1332830.
20. Republic of Türkiye, Ministry of Health, General Directorate of Health Information Systems. Health Statistics Yearbook 2021. IN: Ministry of Health Publication; c2021:133.
21. Cheng A, Zhao Z, Liu H, Yang J, Luo J. The physiological mechanism and effect of resistance exercise on cognitive function in the elderly people. Front Public Health. 2022;10:1013734. doi:10.3389/fpubh. 2022.1013734.
22. Tu Q, Hyun K, Hafiz N, et al. Age-related variation in the provision of primary care services and medication prescriptions for patients with cardiovascular disease. Int J Environ Res Public Health. 2022;19(17):10761. doi:10.3390/ijerph191710761.
23. Ozerkan Cakan F. Changes in cardiovascular physiology in the elderly. Turk Kardiyol Dern Ars. 2017;45(Suppl 5):5-8. doi:10.5543/tkda.2017.89 856
24. Rim D, Henderson LA, Macefield VG. Brain and cardiovascular-related changes are associated with aging, hypertension, and atrial fibrillation. Clin Auton Res. 2022;32(6):409-422. doi:10.1007/s102 86-022-00907-9.
25. Oliveira AC, Cunha PMGM, Vitorino PVO, et al. Vascular aging and arterial stiffness. Arq Bras Cardiol. 2022;119(4):604-615. doi:10.36660/abc.202107 08.
26. Çiflik Bolluk A, Özçakar N. Yaşlılarda Kardiyovasküler Sistem Hastalıklarına Yaklaşım. IN: Türkiye Klinikleri; c2019:69-75.
27. Levitan BM, Ahern BM, Aloysius A, et al. Rad-GTPase contributes to heart rate via L-type calcium channel regulation. J Mol Cell Cardiol. 2021;154:60-69. doi:10.1016/j.yjmcc.2021.01.005
28. Singam NSV, Fine C, Fleg JL. Cardiac changes associated with vascular aging. Clin Cardiol. 2020;43(2):92-98. doi:10.1002/clc.23313.
29. Durmaz E, Ikitimur B, Kilickiran Avci B, et al. The clinical significance of premature atrial contractions: How frequent should they become predictive of new-onset atrial fibrillation. Ann Noninvasive Electrocardiol. 2020;25(3):e12718. doi:10.1111/an ec.12718.
30. Mittal S. Ventricular Ectopic Beats. IN: Insights Into Electrocardiograms with MCQs; c2023:201-212. doi:10.1007/978-981-99-0127-2_16
31. Oliveros E, Patel H, Kyung S, et al. Hypertension in older adults: Assessment, management, and challenges. Clin Cardiol. 2020;43(2):99-107. doi:10.10 02/clc.23303. 
32. Tan ESJ, Lee CH. Obstructive sleep apnea and arrhythmias in the elderly. Curr Sleep Medicine Rep. 2021;7:197-205. doi:10.1007/s40675-021-00 212-3
33. Fadah K, Hechanova A, Mukherjee D. Epidemiology, pathophysiology, and management of coronary artery disease in the elderly. Int J Angiol. 2022;31(4):244-250. doi:10.1055/s-0042-1751234.
34. Magidson PD. The aged heart. Emerg Med Clin North Am. 2022;40(4):637-649. doi:10.1016/j.emc.2022. 06.004.
35. Tyrrell DJ, Goldstein DR. Ageing and atherosclerosis: Vascular intrinsic and extrinsic factors and potential role of IL-6. Nat Rev Cardiol. 2021;18:58-68. doi:10.1038/s41569-020-0431-7
36. Shannon OM, Clifford T, Seals DR, Craighead DH, Rossman MJ. Nitric oxide, aging and aerobic exercise: Sedentary individuals to Master's athletes. Nitric Oxide. 2022;125-126:31-39. doi:10. 1016/j.niox.2022.06.002
37. Akhtar S, Mohanty SK, Singh RR, Sen S. Chronic diseases and productivity loss among middle-aged and elderly in India. BMC Public Health. 2022;22(1):2356.  doi:10.1186/s12889-022-14813-2.
38. Ashikali EM, Ludwig C, Mastromauro L, et al. Intrinsic capacities, functional ability, physiological systems, and caregiver support: A targeted synthesis of effective interventions and international recommendations for older adults. Int J Environ Res Public Health. 2023;20(5):4382. doi:10.3390/ijerph2005 4382
39. Pinckard K, Baskin KK, Stanford KI. Effects of exercise to improve cardiovascular health. Front Cardiovasc Med. 2019;6:69. doi:10.3389/fcvm.2019.00 069.
40. Özlek E, Çekiç EG, Özlek B, et al. Rationale, design, and methodology of the EPIC (Epidemiology of Polypharmacy and Potential Drug-Drug Interactions in Elderly Cardiac Outpatients) study. Turk Kardiyol Dern Ars. 2019;47(5):391-398. doi:10.5543/tkda.2019.27724
41. Takeda A, Martin N, Taylor RS, Taylor SJ. Disease management interventions for heart failure. Cochrane Database Syst Rev. 2019;1(1):CD002752. doi:10.1002/14651858.CD002752.
42. Topuz İ, Gözüm S. A comparison of actual cardiovascular disease risks to the perceptions of middle-aged men: A cross-sectional study. Clin Exp Health Sci. 2022;12(3):607-617. doi:10.33808/clinexp healthsci.984039.
43. Avci IA, Nal B, Ayyildiz M. Assessment of chronic disease prevalence, nutritional habits and healthy lifestyle behaviors in elderly patients. Prog Nutr. 2016;18(1):26-31.
44. Nal B, Aydın Avcı I, Ayyildiz M. The correlation between death anxiety and anxiety in elderly with chronic obstructive pulmonary disease. Progress in Health Sciences. 2016;6(1):63-69. doi:10.5604/01. 3001.0009.5111.