Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.
Department of Medicine (Geriatric Medicine), Dalhousie University, Halifax, NS, Canada.
Adv Exp Med Biol. 2018;1065:389-411. doi: 10.1007/978-3-319-77932-4_25.
Cardiovascular diseases increase dramatically with age in both men and women. While it is clear that advanced age allows more time for individuals to be exposed to risk factors in general, there is strong evidence that age itself is a major independent risk factor for cardiovascular disease. Indeed, there are distinct age-dependent cellular, structural, and functional changes in both the heart and blood vessels, even in individuals with no clinical evidence of cardiovascular disease. Studies in older humans and in animal models of aging indicate that this age-related remodeling is maladaptive. An emerging view is that the heart and blood vessels accumulate cellular and subcellular deficits with age and these deficits increase susceptibility to disease in older individuals. Aspects of this age-dependent remodeling of the heart and blood vessels differ between the sexes. There is also new evidence that these maladaptive changes are more prominent in older animals and humans with a high degree of frailty. These observations may help explain why men and women are susceptible to different cardiovascular diseases as they age and why frail older adults are most often affected by these diseases.
心血管疾病在男性和女性中都会随着年龄的增长而急剧增加。虽然很明显，高龄使得人们有更多的时间接触一般的风险因素，但有强有力的证据表明，年龄本身就是心血管疾病的一个主要独立风险因素。事实上，即使在没有心血管疾病临床证据的个体中，心脏和血管也会发生明显的与年龄相关的细胞、结构和功能变化。在老年人和衰老动物模型中的研究表明，这种与年龄相关的重塑是适应不良的。一个新出现的观点是，心脏和血管随着年龄的增长而积累细胞和亚细胞缺陷，这些缺陷会增加老年人患病的易感性。心脏和血管的这种与年龄相关的重塑在性别之间存在差异。也有新的证据表明，在虚弱程度较高的老年动物和人类中，这些适应不良的变化更为突出。这些观察结果可能有助于解释为什么男性和女性随着年龄的增长容易患上不同的心血管疾病，以及为什么虚弱的老年人最容易受到这些疾病的影响。
