Pathophysiological Mechanisms of Coronary Heart Disease and Arterial Hypertension During Aging
Elizaveta I Bon*, Maksimovich Nye and Znavets PA
ABSTRACT
Cardiovascular diseases remain the leading cause of early disability, loss of working capacity, and mortality in most countries worldwide. Among them, coronary heart disease (CHD) and arterial hypertension (AH) occupy a special place, as their prevalence steadily increases with age. Due to the global aging of the population, the management of elderly and senile patients is gaining not only medical but also pronounced socio-economic significance.
Age is considered one of the key risk factors for CHD. In older age groups, coronary heart disease is a manifestation of a systemic atherosclerotic process that develops against the background of a complex of involutional changes: neurohumoral regulation, lipid and carbohydrate metabolism, hemostasis, the immune system, and vascular wall structure. These changes reduce the body’s adaptive reserves, increase its sensitivity to stress, and aggravate the course of the disease.
Arterial hypertension, especially its isolated systolic form, is also an extremely common condition in older age groups. Its pathogenesis is closely related to the loss of elasticity of large arterial vessels (the aorta and its branches), impaired baroreceptor function, and compensatory cardiac hyperfunction. At the same time, a moderate increase in blood pressure in the elderly may play an adaptive role in the context of age-related decline in cardiac output and deterioration of tissue perfusion.
Thus, the management of elderly and senile patients with CHD and AH requires a comprehensive, individualized approach that takes into account both general pathogenetic patterns and the specific features of clinical presentation, diagnosis, and treatment.
