HEART FAILURE
Clinical Overview

Epidemiology and Pathophysiology

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Normal aging affects preload, afterload, and myocardial contractility.⁸ These changes are not sufficient to produce heart failure, but they make the heart less able to contend with disease-related impairments and allows heart failure to develop earlier.

Preload fibrotic changes cause reduced compliance and slowed relaxation of the ventricles early diastolic filling is reduced up to 50% causing a decrease in preload  Afterload increased stiffness in the aorta decreased baroreceptor sensitivity related to altered stretch receptors within the stiff aorta altered cardiovascular reflex response afterload increases  Contractility reduced strength, force, and speed of contraction due to slower release of calcium. decreased inotropic response to catecholamines and beta-adrenergic stimulation reduction in overall myocardial contractility

The effect of age-related changes in cardiac structure and function are often difficult to distinguish from preexisting disease and the results of lifestyle choices.8 Smoking, poor nutrition, and decreased physical activity result in chronic deconditioning that may significantly affect the cardiovascular function. Disease prevalence increases with age and those older than 75 years may average 3-4 chronic illnesses. Hypertension, coronary artery disease, and diabetes are common diseases in the elderly, and are risk factors for development of heart failure.

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