8/14/2019 Changes With Aging Characteristic CV TPR Blood Vessels Renin-Angiotensin

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Changes with Aging

Characteristic Change OtherCV

TPR Normal d/t arteriosclerosisDz d/t atherosclerosis

Blood Vessels calcification PseudoHTNPulse can feel normal d/t offsetting effects of

arteriosclerosis and Ao stenosis

Renin-Angiotensin System - aldosterone Na+

retention/excretionCatecholamines responsiveness

receptor response receptor response

Reason why max HR w/ agePlasma Norepi , Epi , Cortisol

Baroreceptors sensitivityCO BP HTN >140/80 commonHeart weight, LV thickness,

Dz (vascular, valvular,

myocardial)

Cardiac Index Rest Exercise

EF CO HR EDV Respiration

TLC VC (?) w/FRC RV d/t eleasticityAreterial PO2 VO2 Max Progressively d/t lean m. mass, max HR, deconditioningBody Composition

Weight , then plateau, then Height d/t intervertebral disc s (dessication, etc)

Pathological height loss d/t osteoporosis (usually)

Lean Body Mass (fat-free mass) in body composition affects pharmacokinetics% Body Fat Renal

Glomeruli d/t sclerosis, Basement membraneFlow 10%/decadeCreatinine clearance 133-(0.64 x age)Serum Creatinine Less produced d/t lean body mass loss of mass

offsets clearance

Na+

Retention/ExcretionVascular Responsiveness (ACh) Maximally dilated?Endocrine Renin-Angiotensin, Vit.

D, / EPO, more sensitiveto AVP/ADH (hyperresponse

to osmotic stimulus)

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Characteristic Change OtherThyroid

Anatomical fibrosis, cellular infiltration,follicular atrophy

BMR Linked w/ lean body massBasal O2 Consumption (Whole

Body)

Non-Muscle O2 Consumption Hormones (tT4, fT4, rT3) Minimal if any Female Gonads

Anatomical Loss of follicles, Vesselobliteration, parenchymal

fibrosis, atrophy of corpus

lutea and alicania

Total Gonadotropic Hormones in

Urine

Slow rise until menopause,

then rapid rise, then decline

Estrogen Cycle throughout life, then

decline post-menopause

Clinical Effects Uterine, vaginal, vulvar atrophy; vasomotor

instability; menopause; bone loss

d/t ovarian, estrogen loss

Male Gonads

Prostate sizeLeydig Cells, Seminiferoustubules

Patchy degeneration

Testosterone until post-puberty, thenplateau, slow decline after 35

Glucose

Blood Glucose Glucose Tolerance Higher blood glucose 2hr post-meal some insulin

resistance (post receptor defect)

AndrenalCortisol Suppression w/ dexamethasone

Response w/ stimulationDHEA GH