Arterial Aging from a Gerontological Viewpoint
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概要
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Aging is a set of processes that alter an individual's life as they age. It affects all body systems, but not necessarily at the same time or to the same extent in any individual. Aging also increases susceptibility for diseases. Understanding and potentially modifying factors that act on age can alter the natural history and lead to delay in the onset of disease. Aging impacts on the vascular tree and alters its capability to adapt. Increasing age is associated with an increase in intimal medial thickness (IMT) and with increasing arterial stiffness. Increasing IMT is directly related to an increased risk for coronary artery disease. The presence of increased stiffness is related to systolic blood pressure and increasing pulse pressure which in turn are related to coronary disease. By understanding and modifying aging processes that affect the arteries, atherosclerosis can be modified by potentially altering age-related changes in blood pressure, body mass and serum lipids. Other modifiable environmental and lifestyle factors are likely to affect the arterial aging process and cardiovascular risk. For example, cardiovascular fitness and physical activity decline with increasing age at a relatively fixed rate, even in the fittest individuals. These declines are likely regulated by the aging nervous system, and are observed in a number of species. Factors that overcome these aging changes may positively impact on fitness and minimize aging in the arterial tree. Environmental and socioeconomic factors are increasingly being identified as a risk for vascular disease, and perhaps differential aging. The causes for these differences are not known. However, differences in depression, stress, anger and coping are being considered as potential mechanisms. Such differences argue for a differential regulation within the nervous system that likely involves the hypothalamus and ventrolateral medulla. Vascular aging has a clear impact on well-being and the development of disease.The observations presented here argue that these changes, while cumulative with age, and caused by a number of different processes that act at molecular, cellular and system levels. The capability of identifying and modifying these processes may in the long-term slow aging in the vascular tree and delay or prevent arterial diseases.Age and aging have major impacts on the vascular and cardiac systems. The processes important for disease development are directly impacted by individual age. Lakatta and Levy (2003) have recently explored the importance of aging on the vascular tree and the heart. This review will consider a few of the points they have raised, and suggest other age-related issues that may be important in altering the internal milieu, thus increasing susceptibility to atherosclerosis and cardiovascular diseases.
- 日本脳神経超音波学会の論文