Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-26T05:32:59.580Z Has data issue: false hasContentIssue false

Aging of the heart and the cardiovascular system

Published online by Cambridge University Press:  17 November 2008

DS Fairweather*
Affiliation:
The Radcliffe Infirmary, Oxford, UK
*
DS Fairweather, Nuffield Department of Clinical Medicine, University of Oxford, Radcliffe Infirmary, Oxford OX2 6HE, UK.

Abstract

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Biological gerontology
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Tunick, PA, Freedberg, RS, Ronzon, I.Cardiac finding in the very elderly: analysis of echocardiography in fifty-eight nonagenarians. Gerontology 1990; 136: 206–11.CrossRefGoogle Scholar
2Pinsky, JL, Jette, AM, Branch, LG, Kannel, WB, Feinleib, M.The Framingham disability study: relationship of various coronary heart disease manifestations to disability in older persons living in the community. Am J Public Health 1990; 180: 1363–67.CrossRefGoogle Scholar
3Rossman, I. Mortality and morbidity overview. In: Rossman, I ed. Clinical geriatrics, third edition. Philadelphia: JB Lippincott, 1986: 95113.Google Scholar
4Kuller, LH.Epidemiology of cardiovascular diseases: current perspectives Am J Epidemiol 1976; 104: 425–56.CrossRefGoogle ScholarPubMed
5Fairweather, DS.Aging as a biological phenomenon. Reviews in Clinical Gerontology 1991; 1: 47.CrossRefGoogle Scholar
6Fairweather, DS, Evans, JG. Ageing. In: Cohen, RD, Lewis, B, Alberti, KGMM, Denman, AM eds. The metabolic and molecular basis of acquired disease. London: Bailliere Tindall, 1990: 213–36.Google Scholar
7Fairweather, DS, Campbell, AJ.Diagnostic accuracy. The effects of multiple aetiology and the degradation of information in old age. J R Coll Physicians Land 1991; 25: 105–10.Google ScholarPubMed
8Davies, MJ. Pathology. In: Marling, A, Camm, AJ eds. Heart disease in the elderly. Chichester: John Wiley, 1984: 3757.Google Scholar
9Shock, NW, Greulch, RC, Andres, R, Arenberg, D, Costa, PR, Lakatta, EG, Tobin, JD. Normal human aging: the Baltimore Longitudinal study of aging. Washington D.C.: US Government Printing Office – NIH Publication 842450, November 1984.Google Scholar
10Smith, HL.The relation of the weight of the heart to the weight of the body and of the weight of the heart to age. Am Heart J 1928; 4: 7983.CrossRefGoogle Scholar
11Safronov, VV, Kuzmichev, YG, Modzgvrishvili, RA.Age difference in basic echocardiometric indices. Fiziol Cheloveka 1979; 6: 329–35.Google Scholar
12Hodkinson, I, Pomerance, A, Hodkinson, HM.Heart size in the elderly: a clinicopathological study. J R Soc Med 1979; 72: 1316.Google Scholar
13Melissari, M, Balbi, T, Gennari, M, Olivetti, G.The aging of the heart: weight and structural changes in the left ventricle with age. G Ital Cardiol 1991; 21: 119–30.Google Scholar
14Hutchins, GM. Structure of the aging heart. In: Weisfeldt, ML ed. The aging heart. New York: The Raven Press, 1980: 79.Google Scholar
15Howell, TH.Heart weights among octogenarians. J Am Geriatr Soc 1981; 29: 572–75.CrossRefGoogle ScholarPubMed
16Klima, M, Klima, T. Cardiovascular pathology in old age. In: Luchi, RJ ed. Clinical geriatric cardiology. London: Churchill Livingstone, 1989: 2753.Google Scholar
17Lakatta, EG.Alterations in the cardiovascular system that occur in advanced age. Fed Proc 1979; 38: 163–67.Google Scholar
18Sjogren, AL.Left ventricular wall thickness in 100 subjects without heart disease. Chest 1971; 60: 341–46.Google Scholar
19Gerstenblith, G, Frederiksen, J, Yin, FCP, Fortuin, NJ, Lakatta, EG, Weisfeldt, ML.Echocardiographic assessment of a normal adult aging population. Circulation 1977; 56: 273–78.CrossRefGoogle ScholarPubMed
20Lima, JA, Fleg, JL, Waclawiw, M, Lima, SD, Gerstenblith, G. Cardiac structure and function in elderly women. Is there a distinctive profile? Circulation 1988; 1163.Google Scholar
21Manolio, TA, Levy, D, Garrison, RJ, Castelli, WP, Kannel, WB.Relation of alcohol intake to left ventricular mass: the Framingham Study. J Am Coll Cardiol 1991; 17: 717–21.Google Scholar
22Potter, J, Elahi, D, Tobin, JD, Andres, R.Effect of aging on the cardiothoracic ratio of men. J Am Geriatr Soc 1982; 30: 404409.Google Scholar
23Ensor, RE, Fleg, JL, Kimm, YC, Deleon, EF, Goldman, SM.Longitudinal chest X-ray changes in normal men. J Gerontol 1983; 38: 307–14.Google Scholar
24Van Tosh, A, Lakatta, EG, Fleg, JL et al. Ventricular dimensional changes during submaximal exercise: effect of aging in normal man. Circulation 1980; 62 (4, Pt II): 111129.Google Scholar
25Rodeheffer, R, Gerstenblith, GG, Fleg, JL et al. The impact of age on gated blood pool scans (GBPS) measurements of LV volumes during exercise. Circulation 1981; 64 (4 Pt II): IV–243.Google Scholar
26Rodeheffer, RJ, Gerstenblith, G, Becker, LC, Fleg, JL, Wiesfeldt, ML, Lakatta, EG.Exercise cardiac output is maintained with advancing age in healthy human subjects: Cardiac dilatation and increased stroke volume compensate for diminished heart rate. Circulation 1984; 69: 203–13.Google Scholar
27Fleg, JL, Lakatta, EG.Role of muscle loss in the age-associated reduction in VO2 max. J Appl Physiol 1988; 65: 1147–51.Google Scholar
28Olivetti, G, Melissari, M, Capasso, JM, Anversa, P.Cardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy. Circ Res 1991; 68: 1560–68.CrossRefGoogle ScholarPubMed
29Anversa, P, Palackal, T, Sonnenblick, EH, Olivetti, G, Meggs, LG, Capasso, JM.Myocyte cell loss and myocyte cellular hyperplasia in the hypertrophied aging rat heart. Circ Res 1990; 67: 871–78.Google Scholar
30Hattori, K, Tanaka, M, Sugiyama, S et al. Age-dependent increase in deleted mitochondrial DNA in the human heart: possible contributory factor to presbycardia. Am Heart J 1991; 121: 1735–42.Google Scholar
31Cortopassi, GA, Arnheim, N.Detection of a specific mitochondrial DNA deletion in tissues of older humans. Nucl Acid Res 1990; 18: 6927–33.CrossRefGoogle ScholarPubMed
32Catania, J, Margison, GP, Merry, BJ, Fairweather, DS.DNA methylation falls during in vivo ageing. Age Ageing 1990; 19 (suppl 2): P19.Google Scholar
33Catania, J, Fairweather, DS.Genetic and geromic factors in aging. Reviews in Clinical Gerontology 1991; 1: 106108.Google Scholar
34Weale, R.Aspects of the senescent lens and retina. Reviews in Clinical Gerontology 1992; 2: 79.Google Scholar
35Ji, LL, Dillon, D, Wu, E.Myocardial aging: antioxidant enzyme systems and related biochemical properties. Am J Physiol 1991; 261: 386–92.Google ScholarPubMed
36Strehler, BL, Mark, DDMMildvan, AS, Gee, MV.Rate and magnitude of age pigment accumulation in the human myocardium. J Gerontol 1959; 14: 430–38.Google Scholar
37Frenzel, H.The heart in the elderly: light and electron microscopy findings. Z Kardiol 1985; 7: 1725.Google Scholar
38Davies, I, Fotheringham, AP.Lipofuscin – does it affect cellular performance? Exp Gerontol 1981; 16: 119–25.Google Scholar
39Del Roso, A, De Tata, V, Gori, Z, Bergamini, E.Transmural differences of lipofuscin pigment accumulation in the left ventricle of rat heart during growth and aging. Aging 1991; 3: 1923.Google Scholar
40Weisfeldt, ML.The aging heart. Hasp Pract 1985; 15: 115–30.Google Scholar
41Soyka, J, 1876. Cited in Klima & Klima, 1989.Google Scholar
42Buja, LM, Kkhoi, NB, Roberts, WC.Clinically significant cardiac amyloidosis. Am J Cardiol 1970; 26: 394405.CrossRefGoogle ScholarPubMed
43Hodkinson, HM, Pomerance, A.The clinical significance of senile cardiac amyloidosis: a prospective clinicopathological study. Q J Med 1977; 46: 381–87.Google Scholar
44Waller, BF, Block, T, Barker, BG et al. The old-age heart: aging changes of the normal elderly heart and cardiovascular disease in 12 necropsy patients aged 90 to 101 years. Cardiol Clin 1984; 2: 753–79.Google Scholar
45Pomerance, A.Senile cardiac amyloidosis. Br Heart J 1965; 27: 711–18.Google Scholar
46Meaney, E, Shabetai, R, Bharaave, V.Cardiac amyloidosis, constrictive pericarditis and restrictive cardiomyopathy. Am J Cardiol 1976; 38: 547–56.CrossRefGoogle ScholarPubMed
47Cornwell, GG, Murdock, WL, Kyle, RA, Westermark, P, Pitkanen, P.Frequency and distribution of senile cardiovascular amyloid: a clinicopathologic correlation. Am J Med 1983; 75: 618–23.Google Scholar
48Cornwell, GG, Westermark, P.Senile amyloidosis - a protean manifestation of the ageing process. J Clin Pathol 1980; 33: 1146–52.CrossRefGoogle Scholar
49Woo, P. Amyloidosis. In: Cohen, RD, Lewis, B, Alberti, KGMM, Denman, AM eds. The metabolic and molecular basis of acquired disease. London: Bailliere Tindall, 1990: 363–77.Google Scholar
50Anderton, BH, Brion, J-P.Ultra structural and biochemical basis of Alzheimer's disease. Reviews in Clinical Gerontology 1991; 1: 21.Google Scholar
51Lenkiewicz, JE, Davies, MJ, Rosen, D.Collagen in human myocardium as a function of age. Cardiovasc Res 1971; 5: 549–55.Google Scholar
52Klauser, SC, Schwartz, AB.The aging heart. Clin Geriatr Med 1985; 1: 119–41.Google Scholar
53Medugorac, I.Collagen content in different areas of normal and hypertrophied rat myocardium. Cardiovasc Res 1980; 14: 551–54.Google Scholar
54Frenzel, H, Feimann, J.Age-dependent structural changes in the myocardium of rats; a quantitative light- and electron-microscopic study on the right and left chamber wall. Mech Ageing Dev 1984; 27: 2941.Google Scholar
55GrovermcKay, M, Scholz, TD, Burns, TL, Skorton, DJ.Myocardial collagen concentration and nuclear magnetic resonance relaxation time in the spontaneously hypertensive rat. Ivest Radial 1991; 26: 227–32.CrossRefGoogle Scholar
56Merry, BJ.Effect of dietary restriction on lifespan. Reviews in Clinical Gerontology 1991; 1: 203–13.CrossRefGoogle Scholar
57Cornwell, GG, Thomas, BP, Snyder, DJ.Myocardial fibrosis in aging germ-free and conventional Lobund-Wistar rats: the protective effect of diet restriction. J Gerontol 1991; 46: 167–70.CrossRefGoogle ScholarPubMed
58Jonsson, A, Hallgrimsson, J.Comparative disease patterns in the elderly and the very old: a retrospective autopsy study. Age Ageing 1983; 12: 111–17.CrossRefGoogle Scholar
59Gregory, MA, Olmesdahl, PJ, Whitton, ID.An ultrastructural study of the origin and function of basophilic degeneration in human cardiac muscles. J Pathol 1982; 138: 337–51.Google Scholar
60Davies, MJ, Pomerance, A.Quantitative study of ageing changes in the human sino-atrial node and internodal tracts. Br Heart J 1972; 34: 150–52.CrossRefGoogle ScholarPubMed
61Thery, C, Gosselin, B, Lekieffre, J, Warembourg, H.Pathology of sino-atrial node. Correlations with ECG in 111 patients. Am Heart J 1977; 93: 735–40.Google Scholar
62Davies, MJ, Pomerance, A 1972b. Pathology of atrial fibrillation in man. Br Heart J 1972; 34: 520–25.Google Scholar
63Schwartz, JB, Gibb, WJ, Tran, T.Aging effects on heart rate variation. J Gerontol 1991; 46: 99106.CrossRefGoogle ScholarPubMed
64Kaplan, DT, Furman, MI, Pincus, SM, Tyan, SM, Lipsitz, LA, Goldberger, AL.Aging and complexity of cardiovascular dynamics. Biophys J 1991; 59: 945–59.CrossRefGoogle ScholarPubMed
65Evans, JG, Prior, IAM, Tunbridge, WMG.Age-associated change in QRS axis: intrinsic or extrinsic ageing? Gerontology 1982; 28: 132–37.CrossRefGoogle ScholarPubMed
66Gorman, P, Calatayud, J, Abraham, E.Effects of age and heart disease on the QRS axis during the seventh through the tenth decades. Am J Med 1964; 67: 3943.Google ScholarPubMed
67Simonson, E.The effect of age on the electrocardiogram. Am J Cardiol 1972; 29: 6473.CrossRefGoogle ScholarPubMed
68Bachman, S, Sparrow, D, Smith, LK.Effect of aging on the electrocardiogram. Am J Cardiol 1981; 48: 513–16.Google Scholar
69Lenegre, J.Bilateral bundle branch block. Cardiologia 1966; 48: 134–37.CrossRefGoogle ScholarPubMed
70Roberts, WC, Perloff, JK, Ostantino, T.Severe valvular aortic stenosis in patients over 65 years of age: a clinicopathologic study. Am J Cardiol 1971; 27: 497506.Google Scholar
71Fulkerson, PK, Beaver, BM, Auseon, JC, Grablet, HL.Calcification of the mitral annulus: aetiology, clinical associations, complications and therapy. Am J Med 1979; 66: 967–77.CrossRefGoogle ScholarPubMed
72Mori, H, Oku, Y, Hashiba, K, Seto, M, Mameya, G.The relationship of osteoporosis to mitral annular and aortic valvular calcification in elderly women. J Cardiol 1990; 20: 393–99.Google ScholarPubMed
73Nordin, BEC.Metabolic bone and stone disease. Edinburgh: Churchill Livingstone, 1983.Google Scholar
74Bonella, D, Parker, DJ, Davies, MJ.Accumulation of procollagen in human floppy mitral valves. Lancet 1980; i: 880–81.CrossRefGoogle Scholar
75Hammer, D, Leier, CV, Baba, N, Vasko, JS, Wooley, CF, Pinnell, DR.Altered collagen composition in a prolapsing mitral valve with ruptured chordae tendineae. Am J Med 1979; 67: 863–66.Google Scholar
76James, VJ, McConnell, JF, Capel, M.The d-spacing of collagen from mitral heart valves changes with ageing, but not with collagen type III content. Biochim Biophys Acta 1991; 1078: 1922.Google Scholar
77Mays, PK, McAnulty, RJ, Campa, JS, Laurent, GJ.Age-related changes in collagen synthesis and degradation in rat tissues. Importance of degradation of newly synthesized collagen in regulating collagen production. Biochem J 1991; 276: 307–13.Google Scholar
78Bourliere, F, Vallery-Masson, . Epidemiology and ecology of aging. In: Brocklehurst, JC ed. Textbook of geriatric medicine and gerontology, third edition. London: Churchill Livingstone, 1985: 328.Google Scholar
79Lakatta, EG. Heart and circulation. In: Schneider, EL, Rowe, JW eds. Handbook of the biology of aging, third edition. New York: Academic Press, 1990: 181216.Google Scholar
80Rakusan, K, Poupa, O.Capillaries and muscle fibres in the heart of old rats. Gerontologia 1964; 9: 107–12.Google Scholar
81Rissanen, V, Pyorala, K.Aortic and coronary atherosclerosis in the Finnish population. Atherosclerosis 1974; 19: 221–30.Google Scholar
82O'gorman, DJ, Sheridan, DJ.Abnormalities of the coronary circulation associated with left ventricular hypertrophy. Clin Sci 1991; 81: 703–13.CrossRefGoogle ScholarPubMed
83Lernfelt, B, Landal, S, Svanborg, A.Coronary heart disease at 70, 75 and 79 years of age: a longitudinal study with special reference to sex difference and mortality. Age Ageing 1990; 19: 297303.Google Scholar
84Evans, JG. Epidemiology. In: Martin, A, Camm, AJ eds. Heart disease in the elderly. Chichester: John Wiley & Sons, 1984: 936.Google Scholar
85Cohen, DL.Cardiovascular disease and high cholesterol in old age [Editorial]. Reviews in Clinical Gerontology 1992; 2: 12.CrossRefGoogle Scholar
86Barker, DJ.The intrauterine origins of cardiovascular and obstructive lung disease in adult life. J R Coll Physicians Lond 1991; 25: 129–33.Google Scholar
87Kaunitz, H.Is arteriosclerosis a life prolonging, adaptive process. Mech Ageing Dev 1991; 57: 139–44.Google Scholar
88Templeton, GH, Willerson, JT, Platt, MR, Weisfeldt, M. Contraction duration and diastolic stiffness in aged canine left ventricle. In: Kabayashi, T, Sano, T, Dalla, NS eds. Recent advances in studies on cardiac structure and metabolism: II Heart function and metabolism. Baltimore: University Park Press, 1978: 169–73.Google Scholar
89Swine, JC, Fleg, JC, Lima, J AC.Lima, SD, Shapiro, EP.Age-related changes in left ventricular performance during isometric exercise. J Am Coll Cardiol 1989; 13: 56A.Google Scholar
90Stork, T, Mockel, M, Danne, O, Ewert, C, Muller, R, Bodemann, T, Eichstadt, H, Hochrein, H.Age-related hemodynamic changes during diastole: a combined M-mode and Doppler echo study. Int J Card Imaging 1990; 6: 2330.Google Scholar
91Pearson, AC, Gudipati, CV, Labovitz, AJ.Effects of aging on left ventricular structure and function. Am Heart J 1991; 121: 871–75.Google Scholar
92Xiao, RP, Lakatta, EG.Mechanism of altered beta-adrenergic modulation of the cardiovascular system with aging. Reviews in Clinical Gerontology 1991; 1: 309–22.CrossRefGoogle Scholar
93Roy, CS.The elastic properties of the arterial wall. J Physiol 1882; 3: 125–59.Google Scholar
94Bramwell, JC, Hill, AV.The velocity of the pulse wave in man. Proc R Soc Lond [Biol] 1922; 93: 298306.Google Scholar
95Gozna, ER, Marble, AE, Shaw, A, Holland, JG.Age-related changes in the mechanics of the aorta and pulmonary artery of man. J Appl Physiol 1974; 36: 407–11.Google Scholar
96Nichols, WW, O'rourke, MF, Avolio, AP, Yaginuma, T, Murgo, JD, Pepine, CJ, Conti, CR.Effects of age on ventricular coupling. Am J Cordial 1985; 55: 1179–84.Google Scholar
97Fraticelli, A, Josephson, R, Danziger, R, Lakatta, EG, Spurgeon, H.Morphological and contractile characteristics of rat cardiac myocytes from maturation to senescence. Am J Physiol 1989; 257(H): 259–65.Google Scholar
98Lakatta, EG.Similar myocardial effects of aging and hypertension. Eur Heart J 1990; 11: 2938.CrossRefGoogle ScholarPubMed
99Hass, HE.Elastic tissue II: a study of the elasticity and tensile strength of elastic tissue isolated from human aorta. Arch Pathol 1942; 29: 971–81.Google Scholar
100Hass, HE.Elastic tissue III: relation between the structure of the aging aorta and the properties of the isolated aortic elastic tissue. Arch Pathol 1943; 34: 2945.Google Scholar
101Lansing, AI. Elastic tissue. In: The arterial wall: aging, structure and chemistry. Baltimore: Williams and Wilkins, 1959: 136–60.Google Scholar
102Ting, CT, Brin, KP, Lin, SJ et al. Arterial haemodynamics in human hypertension. J Clin Invest 1986; 78: 1462–71.Google Scholar
103Yin, FCP, Weisfeldt, ML, Milnor, WR.Role of aortic input impedance in the decreased cardiovascular response to exercise with aging in dogs. J Clin Invest 1981; 68: 2838.CrossRefGoogle ScholarPubMed
104Froehlich, JP, Lakatta, EG, Beard, E, Spurgeon, HA, Weisfeldt, ML, Gerstenblith, G.Studies of sarcoplasmic reticulum function and contraction duration in young and aged rat myocardium. J Mol Cell Cardiol, 1978; 10: 427–38.Google Scholar
105Rumberger, E, Timmermann, J.Age-changes of the force-frequency relationship and the duration of action potential of isolated papillary muscles of the guinea pig. Eur J Appl Physiol 1976; 35: 277–84.Google Scholar
106Frolkis, VV, Bezrukov, BB, Shevchuk, VG.Haemodynamics and its regulation in old age. Exp Gerontal 1975; 10: 251–56.Google Scholar
107Narayanan, N.Differential alterations in ATP-supported calcium transport activities of sarcoplasmic reticulum and sarcolemma of aging myocardium. Biochim Biophys Acta 1981; 678: 442–59.Google Scholar
108Guarnieri, T, Filburn, CTR, Zitnik, G, Roth, GS, Lakatta, EG.Contractile and biochemical correlates of beta-adrenergic stimulation of the aged heart. Am J Physiol 1980; 239 (H): 501508.Google ScholarPubMed
109Lakatta, EG, Gerstenblith, G, Angell, CS, Shock, NW, Weisfeldt, ML.Diminished inotropic response of aged myocardium to catecholamines. Circ Res 1975; 36: 262–69.CrossRefGoogle ScholarPubMed
110Spurgeon, HA, Steinback, MF, Lakatta, EG.Chronic exercise prevents characteristic age-related changes in rat cardiac contraction. Am J Physiol 1983; 244 (H): 513–18.Google Scholar
111Effron, MB, Bhatnagar, GM, Spurgeon, HA, Ruano-Arroyo, G, Lakatta, EG.Changes in myosin isoenzymes, ATPase activity, and contraction duration in rat cardiac muscles with aging can be modulated by thyroxine. Circ Res 1987; 60: 238–45.Google Scholar
112Capasso, JM, Malhorta, A, Scheuer, J, Sonnenblick, EH.Myocardial biochemical, contractile and electrical performance following imposition of hypertension in young and old rats. Circ Res 1986; 58: 445–60.Google Scholar
113Schuyler, GT, Yarbrough, LR. 1990b Comparison of myosin and creatinine kinase isoforms in left ventricles of young and senescent Fischer 344 rats after treatment with triiodothyronine. Mech Ageing Dev 1990; 56: 3948.Google Scholar
114Everett, AW, Sinha, AM, Umeda, PK, Jakovcic, S, Rabinowitz, M, Zak, R.Regulation of myosin synthesis by thyroid hormone: relative changes in the alpha and beta-myosin heavy chain mRNA levels in rabbit heart. Biochem J 1984; 23: 1596–99.Google Scholar
115O'neill, L, Holbrook, NJ, Fargnoli, J, Lakatta, EG.Progressive change from young adult age to senescence in mRNA for rat cardiac myosin heavy chain genes. Cardioscience 1991; 2: 15.Google Scholar
116Schuyler, GT, Yarbrough, LR.Effects of age on myosin and creatinine kinase isoforms in left ventricles of Fischer 344 rats. Mech Ageing Dev 1990; 56: 2338.Google Scholar
117Lakatta, EG, Yin, FCP. Myocardial Aging: Functional Alteration And Related Cellular Mechanisms. Am J Physiol 1982; 242 (H): 927–41.Google Scholar
118Brandfonbrener, M, Landowne, M, Shock, NW.Changes in cardiac output with age. Circulation 1955; 12: 557–66.Google Scholar
119Julius, S, Antoon, A, Whitlock, LS, Conway, J.Influence of age on the hemodynamic response to exercise. Circulation 1967; 36: 222–30.Google Scholar
120Fleg, JL, Lakatta, EG. Cardiovascular disease in old age. In: Rossman, I ed. Clinical geriatrics, third edition. Philadelphia: JB Lippincott Co, 1986: 169–96.Google Scholar
121Fowlie, S.Aging, fitness and muscular performance. Reviews in Clinical Gerontology 1991; 1: 327.Google Scholar
122Avolio, AP, Fa-Quan, D, Wei-Qiang, L et al. Effect of aging on arterial distensibility in populations with high and low prevalence of hypertension: comparison between urban and rural communities in China. Circulation 1985; 71: 202–10.Google Scholar
123Shaper, AG, Wright, DH, Kyobe, J.Blood pressure and body build in three nomadic tribes of Northern Kenya. East Afr Med J 1969; 46: 273–81.Google Scholar
124Komachi, Y, Lida, M, Chimamota, T, Chikayama, Y, Takahashi, H, Konishi, M, Tominaga, S.Geographic and occupational comparisons of risk factors in cardiovascular diseases in Japan. Jpn Circ J 1971; 35: 189856.Google Scholar
125Oliver, WJ, Cohen, EL, Neil, JV.Blood pressure, sodium intake and sodium related hormone in the Yanomamo Indians: a ‘No Salt’ culture. Circulation 1975; 52: 146–51.Google Scholar
126Haidet, GC, Parsons, D.Reduced exercise capacity in senescent beagles: an evaluation of the periphery. Am J Physiol 1991; 260 (H): 173–82.Google Scholar
127Frontera, WR, Meredith, CN, O'reilly, KP, Knuttgen, HG, Evans, WJ.Strength conditioning in older men: skeletal muscle hypertrophy and improved function. J Appl Physiol 1988; 64: 1038–44.Google Scholar
128Heath, GW, Hagberg, JM, Ehsani, AA, Holloszy, JO.A physiological comparison of young and older endurance athletes. J Appl Physiol 1981; 51: 634–40.Google Scholar
129Grimby, G, Slatin, B.Physiological analysis of physically well-trained middle-aged and old athletes. Acta Med Scand 1966; 179: 512–26.Google Scholar
130Danziger, RS, Tobin, JD, Becker, LC, Lakatta, EE, Fleg, JL.The age-associated decline in glomerular filtration in healthy normotensive volunteers: lack of relationship to cardiovascular performance. J Am Geriatr Soc 1990; 38: 1127–32.Google Scholar
131Collins, KJ.The autonomic nervous system in old age. Reviews in Clinical Gerontology 1991; 1: 337–45.Google Scholar
132Davies, HEF.Respiratory change in heart rate, sinus arrhythmia in the elderly. Gerontol Clin 1975; 17: 96102.Google Scholar
133Barringer, DL, Bunag, RD.Autonomic regulation of reflex bradycardia in rats decline with age. ExpGerontol 1991; 26: 6575.Google Scholar
134Gribbin, B, Pickering, TG, Sleight, P, Peto, R.Effect of age and high blood pressure on baroreflex sensitivity in man. Circ Res 1971; 29: 424–31.Google Scholar
135Mancia, G, Clerouz, J, Daffonchio, A, Ferrari, AU, Giannattasio, C, Grassi, G.Reflex control of circulation in the elderly. Cardiovasc Drugs Ther 1991; 4 (suppl 6): 1223–28.Google Scholar
136Rothbaum, DA, Shaw, DJ, Angell, CS, Shock, NW.Cardiac performance in the unanaesthetized senescent male rat. J Gerontol 1973; 28: 283–90.Google Scholar
137Hajduczok, G, Chapleau, MW, Johnson, SL, Abboud, FM.Increase in sympathetic activity with age I. Role of impairment of arterial baroreflexes. Am J Physiol 1991; 260 (H): 1113–20.Google Scholar
138Kalhfleisch, JH, Stowe, DF, Smith, JJ.Evaluation of the heart rate response to the Valsalva manoeuvre. Am Heart J 1978; 95: 707–84.Google Scholar
139Gooden, BA, Holdstock, G, Hampton, JR.The magnitude of the bradycardia induced by face immersion in patients convalescing from myocardial infarction. Cardiovasc Res 1978; 12: 239–42.Google Scholar
140Lye, M, Vargas, E. Postural hypotension. In: Coodley, EL ed. Geriatric heart disease. Littleton, MA: PSG Publishing Co, 1985: 189200.Google Scholar
141Mader, SL, Josephson, KR, Rubenstein, LZ.Low prevalence of postural hypotension among community-dwelling elderly. JAMA 1978; 258: 1511–14.Google Scholar
142Wollner, L, McCarthy, ST, Soper, NOW, Macy, DJ.Failure Of Cerebral Autoregulation As A Cause Of Brain Dysfunction In The Elderly. Br Med J 1979; 1: 1117–18.Google Scholar