Abstract
Age-related changes in cardiac and vascular function are associated with increased risk of cardiovascular mortality and morbidity. The aim of the present study was to define the effect of age on the relationship between cardiac and vascular function. Haemodynamic and gas exchange measurements were performed at rest and peak exercise in healthy individuals. Augmentation index was measured at rest. Cardiac power output, a measure of overall cardiac function, was calculated as the product of cardiac output and mean arterial blood pressure. Augmentation index was significantly higher in older than younger participants (27.7±10.1 vs. 2.5±10.1%, P<0.01). Older people demonstrated significantly higher stroke volume and mean arterial blood pressure (P<0.05), but lower heart rate (145±13 vs. 172±10 beats/min, P<0.01) and peak oxygen consumption (22.5±5.2 vs. 41.2±8.4ml/kg/min, P<0.01). There was a significant negative relationship between augmentation index and peak exercise cardiac power output (r=−0.73, P=0.02) and cardiac output (r=−0.69, P=0.03) in older participants. Older people maintain maximal cardiac function due to increased stroke volume. Vascular function is a strong predictor of overall cardiac function in older but in not younger people.
Highlights
Age-associated changes in cardiac and vascular function are identified as a major risk factor for cardiovascular morbidity and mortality, with older patients having a higher risk of having cardiovascular morbidity and mortality (Westerhof and O’Rourke, 1995; Shih et al, 2011; McEniery et al, 2005; Lakatta, 2002; Franklin, 2005)
The present study is the first to demonstrate the strength of the relationship between vascular function and cardiac pumping capability
Primary findings indicate a significant relationship between augmentation index and peak exercise cardiac power output, implying that vascular function is a strong predictor of cardiac pumping capability in older people
Summary
Age-associated changes in cardiac and vascular function are identified as a major risk factor for cardiovascular morbidity and mortality, with older patients having a higher risk of having cardiovascular morbidity and mortality (Westerhof and O’Rourke, 1995; Shih et al, 2011; McEniery et al, 2005; Lakatta, 2002; Franklin, 2005). The age associated changes that occur are present even in the absence of hypertension or clinically apparent cardiovascular disease (Lakatta, 2002). Stiffening of arteries is commonly reported and leads to an increased systolic blood pressure (Takazawa et al, 1996; Jakovljevic et al, 2010) To overcome these vascular changes and increased afterload, the heart needs to impart more energy into the vascular system by generating more pressure. This may lead to an increase in left ventricular wall thickness and mass with ageing, lowering the threshold for clinical signs and symptoms. Assessment of vascular function is one commonly used method recognised as an important prognostic index and a potential target for therapeutic intervention in CVD and impact upon clinical care (DeLoach and Townsend, 2008; Weber et al, 2004)
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