Cardiovascular Ageing in Health Sets the Stage for Cardiovascular Disease

The incidence and prevalence of coronary disease, hypertension, heart failure and stroke increase exponentially with advancing age. While epidemiologic studies have discovered that aspects of lifestyle and genetics are risk factors for these diseases, age, per se, confers the major risk. Thus, it is reasonable to hypothesise that specific pathophysiological mechanisms that underlie these diseases become superimposed on cardiac and vascular substrates that have been modified by an ‘ageing process’, and that the latter modulates disease occurrence and severity. In order to unravel this age−disease interaction, the nature of the ageing process in the heart and vasculature requires elucidation. Some aspects of the current understanding of ageing of the heart and blood vessels in the absence of apparent disease are the focus of this review. (Heart, Lung and Circulation 2002; 11: 76−91)