Chapter 6: Review of the Aging of the Physiological Systems

The Cardiovascular System:

The functions of the Cardiovascular System:

1. Maintains homeostasis by transferring oxygen, nutrients, and hormones to other organ systems.
2. Provides defense mechanisms through white blood cells.
3. Regulates body temperature and contributes to acid-base balance within the range of pH 7.35 – 7.45

Aging Changes in Cardiovascular Structure:

- Enlargement of heart chambers and coronary cells occurs with age, increased thickening of heart
walls, especially in the left ventricle.
o The enlargement and thickening cause a decline in ventricle flexibility and an overall increase
in weight of about 1.5 grams/year in women and 1 gram/year in men from 30 – 90 yrs/old.
- Decrease myocardial cells to approximately 40 – 50% between ages 20 – 90 years old.
o However, recent studies have concluded that women maintain myocardial cell numbers with
age.
- Increased arterial wall thickening due to increased levels of collagen and decreased level of elastin.
o Leading to hypertension pathophysiology characterized by increased blood velocity from the
aorta to the systemic arterial system.
- Peripheral arteries can show increased stiffness due to accumulating mineral (calcium), lipid, and
collagen residues.
- All 4 cardiac valves increase in circumference in older adults, with the greatest increase occurring in
the aortic valve.
- SA and Atrioventricular nodes demonstrate loss of pacemaker cells to 10% and due to calcifications of
cardiac muscles.

Cardiovascular Aging Mechanisms:

- Free radicals
o Presence of lipofuscin, a brown pigment found in aging cells, relates to the oxidative mechanisms.
Lipofuscin may destroy mitochondrial functioning and increased productions of free radicals.
o Increased levels of free radicals can foster apoptosis.
- Apoptosis can have detrimental effects on cardiovascular structure and functioning.
o Triggered by:
 Elevated levels of noradrenaline
 Initiation of renin-angiotensin system
 Gene expression
 Changes in messanger RNA associated with sarcoplasmic reticulum and the
related enzyme ATPase.

Cardiovascular Functional Changes with Age:

- Elongation of muscle contraction and relaxation phase
o Correlated with extended release of calcium and as well as decline in calcium reuptake.
- Increased left ventricular end-diastolic pressure
o Increased arterial stiffness along with extended relaxation period
o Demonstrated by a decline in pressure at the beginning of diastolic filling and an increase in
pressure during late diastolic filling
- Increased pressure during ventricular systole
o Increased aortic stiffening and left ventricular hypertrophy.

No change with age:

- Stroke volume and ejection fraction

Vascular aging:
- Increased resistance in the aorta, arterial wall and vascular periphery.
- Blood viscosity increases between the ages 20 and 70 years.
- Muted Hypertension = cardiovascular symptoms of hypertension parallel the usual aging changes.

Autonomic Nervous System Aging Effects:

- Orthostatic Hypotension
o Caused by decreased reaction of the entire system, both myocardial and vascular, to ß-adrenergic
stimulus as well as reduced baroreflex activity relating to an imbalance in neuroendocrine control.
 o Norepinephrine concentrations increase with age leading to overstimulation of ß-adrenoceptors
which triggers vessel dilation, as a result BP becomes unstable and hypotension may result.

Exercise and Aging

- Cardiovascular condition during exercise is usually measured using maximum oxygen
consumption(VO2max), which equals the sum of cardiac output and systemic oxygen reserve.
- VO2max = cardiac output + systemic oxygen reserve.
- Declines by 10% by age 20 and 50% by age 80

- Cardiovascular reserve is best measured using maximum cardiac output, which is equal to HR
multiplied by stroke volume during exercise.
- Cardiovascular reserve = Cardiac output = HR x SV
- Continued exercise:
o End-diastolic volume increase, producing greater stroke volume with unchanged cardiac output
o Decreased HR and contractility, decreased peak heart rate ejection fraction

The Respiratory System:

- The respiratory system is composed of the mouth, nose, pharynx, trachea (windpipe), and lungs as
well as the diaphragm.
- Pharynx = oxygen absorbs water vapor and is warmed.
- Alveoli = tiny, spongy air sacs functional units of the lungs and the site of gas exchange, approximately
600million in the average.
- Albeit reverse = the exchange of blood gas (oxygen and carbon dioxide) through the process known
as diffusion.
- Elastic tissue = allows alveoli to expand and recoil. The more the alveoli can expand and recoil, the
more oxygen they can bring in and the more carbon dioxide they can expel.
- Surfactant = substance secreted by alveoli that reduces surface tension within the lungs.
o the reduction of surface tension helps to keep the lungs from collapsing after each breath.
- Diaphragm = is a sheet of muscles located across the bottom of the chest.
o To allow for the intake of oxygen, the rib muscles contract and push the ribs up and out while the
diaphragm contracts and is pulled downward.

Volumes Definition Age-related

Tidal Volume (TV) Amount of air inspired and expired during a normal Decrease
breathing.
Inspiratory Reserve Amount of air that can be inspired after maximum Decrease
Volume (IRV) inspiration
Expiratory Reserve Amount of air that can be expired after maximum Decrease
Volume (ERV) expiration
Residual Volume (RV) Amount of air remaining in the lungs following maximum Increase
expiration
Forced Expiratory Volume Amount of air that can be forcefully expelled in 1 sec. Decrease
(FEV)

Capacity Definition Age-related

Total lung capacity (TLC) Maximum capacity to which the lungs can expand during No change
maximum inspiratory effort
Vital capacity (VC) Amount of air that can be expelled following maximum Decrease
inspiration
Inspiratory capacity (IC) Maximum amount of air that can be inspired after Decrease
reaching the end of a normal expiration
Functional Residual Amount of air remaining in the lungs following a normal Increase
capacity (FRC) expiration

Aging of the Respiratory System

Alveoli
- Becomes flatter and shallower, decrease in the amount of tissue dividing individual alveoli
- Decrease in the alveolar surface area.
 - The volume of blood distributed to the pulmonary circulation declines with age due to a decreasing
number of capillaries per alveolus.
- Impaired efficient passage of oxygen to the blood.
Lung elasticity
- Decrease lung elasticity changes the elastic recoil properties of the lungs.
- Loss of elastic recoil causes the lungs to close prematurely, trapping air inside and preventing the
lungs from emptying completely.
- Due to the effects of the gravity, more blood flows through the lower than the upper portion of the
lungs. However, less air reaches the lower portion of the lungs which has a greater capillary network
and blood supply for oxygen delivery, thus there is decrease amount of gas exchange.
Chest wall
- Becomes stiffer due to calcification of the cartilage that attaches the ribs to the breastbone.
o Reduces the ability to expand during inhalation and contract during exhalation
- Diaphragm may weaken up to 25% thus limiting respiration.
Changes in Respiratory Measures:
-