Chapter 21: Cardiovascular Function & Aging

Cardiovascular Function & Aging overview examines cardiovascular health and function in the elderly, noting that heart disease is the primary cause of death and disability in this demographic. Aging brings structural and physiological changes, including a thickened left ventricular wall, increased vessel rigidity due to collagen buildup, and a reduction in the heart's pacemaker cells, which decreases overall cardiac reserve and response to stress. A major focus is placed on hypertension, frequently referred to as a silent killer, and the prevalence of isolated systolic hypertension among older adults. The text identifies both nonmodifiable risk factors like age and family history, and modifiable factors such as tobacco use, obesity, and physical inactivity. It delves into the pathophysiology of coronary artery disease, noting that older patients, particularly women, often present with atypical symptoms like fatigue, syncope, or confusion rather than classic chest pain. Conditions such as atrial fibrillation are highlighted for their significant role in increasing stroke risk, alongside the management of other arrhythmias through pacemakers and pharmacological therapy. The summary also covers congestive heart failure, explaining the differences between systolic and diastolic failure and the nursing role in managing fluid volume and activity tolerance. Valvular diseases, specifically aortic stenosis and mitral regurgitation, are discussed as common results of the aging process. Additionally, the text addresses peripheral artery occlusive disease and venous disorders, emphasizing the importance of foot care and circulation. Finally, it explores the impact of anemia on the elderly, detailing how a lower oxygen-carrying capacity in the blood can lead to profound fatigue and functional decline, requiring targeted nutritional and medical interventions.