Author + information
- Received April 23, 2019
- Revision received June 26, 2019
- Accepted June 27, 2019
- Published online August 5, 2019.
- Filippos Triposkiadis, MD, PhDa,
- Andrew Xanthopoulos, MD, PhDa and
- Javed Butler, MD, MPH, MBAb,∗ (, )@JavedButler1
- aDepartment of Cardiology, Larissa University General Hospital, Larissa, Greece
- bDepartment of Medicine, University of Mississippi, Jackson, Mississippi
- ↵∗Address for correspondence:
Dr. Javed Butler, Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, Missouri 39216.
• Cardiovascular aging leads to a progressive decline in structure and function.
• Mitochondria are central controllers of the aging process.
• Risk factors/comorbidities on top of cardiovascular aging promote HF.
• Lifestyle modifications reduce risk and should be implemented from childhood.
Heart failure (HF) is a clinical syndrome that usually develops in the elderly. Complex interactions of the cardiovascular aging process with risk factors (obesity, hypertension, and atherosclerosis), comorbidities (anemia, chronic kidney disease, diabetes, and so on), and disease modifiers (sex, genes, others) contribute to the development of HF phenotype and outcome. A conglomerate of cellular and molecular mechanisms underlies the effects of aging on cardiovascular function, the most important being excessive oxidative stress and chronic low-grade inflammation superimposed on the limited cardiac regeneration capacity. Notably, a sizeable percentage of elderly HF patients have cardiac amyloidosis, an HF precipitator. This review summarizes the current published data on the mechanisms of cardiovascular aging as they contribute to the development of HF phenotype and outcome.
Dr. Triposkiadis has received research support and honoraria from Amgen, Bayer, Boehringer Ingelheim, Elpen, Lilly, Menarini, Merck, Novartis, Sanofi, Servier, Vianex, and WinMedica. Dr. Butler has received research support from the National Institutes of Health, Patient Centered Outcomes Research Institute, and the European Union; has served as a consultant for Abbott, Adrenomad, Amgen, Array, AstraZeneca, Bayer, BerlinCures, Boehringer Ingelheim, Bristol-Myers Squibb, Cardiocell, Corvidia, CVRx, G3 Pharmaceutical, Innolife, Janssen, Lantheus, LinaNova, Luitpold, Medtronic, Merck, Novartis, Novo Nordisk, Relypsa, Roche, Sanofi, SC Pharma, StealthPeptide, V-Wave Limited, Vifor, and ZS Pharma; and has participated in educational programs for Medscape. Dr. Xanthopoulos has reported that he has no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received April 23, 2019.
- Revision received June 26, 2019.
- Accepted June 27, 2019.
- 2019 American College of Cardiology Foundation
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