Abstract
The most important advance in our understanding of the physiology of aging has been the recognition of the need to distinguish clearly between processes of aging and age-related disease. Only those manifestations of altered tissue and organ system function and structure which are universally present in all elderly individuals, and which increase in severity or magnitude with increasing age, represent aging. Changes in function or structure which are not universally present or which do not demonstrate a direct relationship between severity and chronologic age reflect age-related disease. Sixty-five percent of the geriatric population has definable cardiovascular disease; therefore, it is futile to attempt to assess the intrinsic effects of aging on cardiovascular function using large-scale epidemiologic investigations alone. Even for patients in the seventh decade of life free of cardiac symptoms, there is a 12% incidence of coronary artery disease, a figure which does not include those individuals with other forms of cardiovascular pathology such as valvular dysfunction or hypertension.
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