Signs of aging in the cardiovascular system. Age-related changes in the circulatory system in old age. Nervous system and vascular and heart health

H The steady aging of the population of developed countries increases specific gravity cardiovascular diseases in the general structure of morbidity, and consequently, leads to an increase in the number of elderly patients in the practice of doctors of many specialties. Therefore, knowledge of the geriatric aspects of cardiology is an important element of knowledge not only for a modern cardiologist, but also for a geriatrician, family doctor and general practitioner.

Until recently, there was an opinion about the need for only symptomatic treatment of cardiovascular diseases (CVD) in the elderly and the insignificant effect of drug intervention on life prognosis at this age. Meanwhile, large clinical studies convincingly show that the patient's age is not an obstacle to the active medical and surgical treatment of many cardiovascular diseases - coronary artery disease, arterial hypertension, stenosing atherosclerosis of the main arteries, and heart rhythm disturbances. Moreover, since the absolute risk of cardiovascular complications is higher in the elderly, treatment of CVD in the elderly is even more effective than in young and middle-aged people.

Treatment goals for cardiovascular disease in the elderly

As in other age groups, the main goals of treatment in the elderly are to improve the quality and increase life expectancy. For a doctor familiar with the basics of geriatrics and the specifics of clinical pharmacology in the elderly, both of these goals are achievable in most cases.

What is important to know when prescribing treatment for the elderly?

Within the framework of this article, the features of treatment in elderly patients with the most common cardiovascular diseases are considered:

Arterial hypertension, incl. isolated systolic hypertension
Heart failure

Arterial hypertension in the elderly

Arterial hypertension (AH), according to various estimates, occurs in 30-50% of people over 60 years of age. Diagnosis and treatment of this disease have a number of important features (Table 4). The elderly need to measure blood pressure (BP) especially carefully, since they often have “pseudohypertension”. The reasons for this are both the rigidity of the main arteries of the extremities and the large variability in systolic blood pressure. In addition, orthostatic reactions are characteristic of elderly patients (due to violations of the baroreceptor apparatus), therefore, it is strongly recommended to compare blood pressure in the patient's supine position and immediately after moving to a vertical position.

Due to the high prevalence of hypertension, especially the isolated increase in systolic blood pressure among the elderly, this disease has long been considered as some kind of relatively benign age change, the active treatment of which could worsen the state of health due to an excessive decrease in blood pressure. They also feared more than at a young age, the number side effects drug therapy. Therefore, doctors resorted to lowering blood pressure in the elderly only in the presence of clinical symptoms (complaints) associated with increased blood pressure. However, by the early 1990s, it was shown that regular long-term antihypertensive therapy significantly reduces the risk of major cardiovascular complications of hypertension - stroke, myocardial infarction and cardiovascular mortality. A meta-analysis of 5 randomized clinical trials, including more than 12,000 elderly patients (aged >60 years), showed that an active decrease in blood pressure was accompanied by a decrease in cardiovascular mortality by 23%, cases of coronary artery disease - by 19%, cases of heart failure - by 48%, the frequency of strokes - by 34%.

A review of the main prospective randomized trials showed that in elderly patients with hypertension, drug-induced reduction in blood pressure for 3-5 years significantly reduces the incidence of heart failure by 48%.

Thus, today there is no doubt that elderly patients with hypertension receive a real benefit from lowering blood pressure. However, after the diagnosis is made and the decision on the treatment of an elderly patient with hypertension is made, a number of circumstances must be taken into account.

Older people respond very well with lowering blood pressure to salt restriction and weight loss. Starting doses of antihypertensive drugs are half the usual starting dose. Dose titration is slower than in other patients. You should strive for a gradual decrease in blood pressure to 140/90 mm Hg. (with concomitant diabetes mellitus and renal failure, the target level of blood pressure is 130/80 mm Hg). It is necessary to take into account the initial level of blood pressure, the duration of hypertension, the individual tolerance of lowering blood pressure. The concomitant decrease in diastolic blood pressure in patients with isolated systolic hypertension is not an obstacle to continuing therapy. In the study SHEP the average level of diastolic blood pressure in the group of treated patients was 77 mm Hg, and this corresponded to an improved prognosis.

Thiazide diuretics, b-blockers and their combinations were effective in terms of reducing the risk of cardiovascular complications and mortality in elderly patients with hypertension, and diuretics (hydrochlorothiazide, amiloride) had an advantage over b-blockers. Recently completed major study ALLHAT clearly confirmed the benefit of diuretics in the treatment of hypertension in all age groups. In the 7 Report of the US Joint National Committee on the detection, prevention and treatment of arterial hypertension (2003), diuretics play a leading role both in monotherapy and in combination treatment of hypertension. A clinical trial is currently underway HYVET involving 2100 patients with arterial hypertension aged 80 and over. Patients will be randomized to placebo and the diuretic indapamide (including in combination with the ACE inhibitor perindopril). The target BP level in this study is 150/80 mmHg, the primary endpoint is cerebral stroke, and the secondary endpoint is total and cardiovascular mortality.

Studies have shown the effectiveness of a calcium antagonist amlodipine (Amlovas) . The advantage of using amlodipine in reducing blood pressure compared with another calcium antagonist, diltiazem, has been shown. The duration of action of amlodipine is 24 hours, which facilitates a single dose per day and provides ease of use. In the study THOMS there was a decrease in the mass index of the left ventricular myocardium in the group of patients taking amlodipine.

ACE inhibitors are the drugs of choice for at least two categories of elderly patients with hypertension - 1) with left ventricular dysfunction and/or heart failure; 2) with accompanying diabetes. This is based on a proven reduction in cardiovascular mortality in the first case and a slowdown in the development of kidney failure in the second. In case of intolerance, ACE inhibitors can be replaced by angiotensin receptor antagonists.

a-blockers (prazosin, doxazosin) are not recommended for the treatment of hypertension in the elderly due to the frequent development of orthostatic reactions. In addition, in a large clinical trial ALLHAT an increase in the risk of heart failure during the treatment of hypertension with a-adrenergic blockers has been shown.

Heart failure in the elderly

Currently, chronic heart failure (CHF) affects 1-2% of the population in developed countries. Annually, chronic heart failure develops in 1% of people over 60 years of age and in 10% of people over 75 years of age.

Despite the significant progress made in the last decades in the development of therapeutic algorithms for the treatment of CHF using various drugs and their combinations, the specifics of the treatment of elderly and elderly patients remain poorly understood. The main reason for this turned out to be the targeted exclusion from most prospective clinical trials on the treatment of CHF in people over 75 years of age - primarily women (who make up more than half of all elderly people with CHF), as well as people with concomitant diseases (also, as a rule, the elderly). Therefore, prior to obtaining data from clinical trials specifically designed for the population of elderly and elderly people with CHF, one should be guided by proven principles for the treatment of CHF in middle-aged people - taking into account the above age features elderly and individual contraindications. Elderly patients with CHF are prescribed ACE inhibitors, diuretics, b-blockers, spironolactone as drugs proven to improve survival and quality of life. With supraventricular tachyarrhythmias against the background of CHF, digoxin is very effective. If it is necessary to treat ventricular arrhythmias against the background of CHF, preference should be given to amiodarone, since it minimally affects myocardial contractility. In severe bradyarrhythmias against the background of CHF (sick sinus syndrome, intracardiac blockades), the possibility of implanting a pacemaker should be actively considered, which often greatly facilitates the possibilities of pharmacotherapy.

Timely detection and elimination/correction of concomitant diseases, often hidden and asymptomatic (malnutrition, anemia, thyroid dysfunction, liver and kidney diseases, metabolic disorders, etc.), is extremely important for the successful treatment of CHF in the elderly.

Stable coronary artery disease in the elderly

The elderly make up the majority of CAD patients. Almost 3/4 of deaths from coronary artery disease occur among people over 65 years of age, and almost 80% of people who die from myocardial infarction belong to this age group. At the same time, in more than 50% of cases, the death of people over 65 years of age occurs from complications of coronary artery disease. The prevalence of coronary artery disease (and, in particular, angina pectoris) in young and middle age is higher among men than among women, however, by the age of 70-75, the frequency of coronary artery disease among men and women is compared (25-33%). Annual mortality among patients in this category is 2-3%, in addition, another 2-3% of patients may develop non-fatal myocardial infarction.

Features of IHD in the elderly:

Atherosclerosis of several coronary arteries at once
Stenosis of the left coronary artery is common
Decreased left ventricular function is common
Often there are atypical angina pectoris, painless myocardial ischemia (up to painless MI)

The risk of complications during planned invasive studies in the elderly is slightly increased, therefore elderly age should not serve as an obstacle to referring the patient to coronary angiography.

Features of the treatment of stable coronary artery disease in the elderly

When choosing drug therapy for elderly patients, it should be remembered that the treatment of coronary artery disease in the elderly is carried out according to the same principles as in young and middle age, however, taking into account some features of pharmacotherapy (Table 5.6).

The effectiveness of drugs prescribed for coronary artery disease, as a rule, does not change with age. Active antianginal, anitischemic, antiplatelet and lipid-lowering therapy can significantly reduce the incidence of coronary artery disease complications in the elderly. According to indications, all groups of drugs are used - nitrates, b-blockers, antiplatelet agents, statins. However, evidence-based studies specifically focused on the treatment of coronary artery disease in older and elderly people are still lacking. At the same time, the proven benefit of a calcium channel blocker amlodipine at a dose of 5-10 mg / day in reducing the frequency of episodes of myocardial ischemia (data from Holter monitoring). The reduction in the frequency of pain attacks compared with placebo makes the use of the drug promising in this category of patients, especially in those who suffer from hypertension. In recent years, clinical studies have been conducted specifically on the effectiveness of drug treatment ischemic heart disease in the elderly.

Summary of studies on secondary lipid-lowering prevention with statins LIPID , CARE and 4S suggest that with a comparable reduction in the relative risk of cardiovascular complications among young and elderly patients, the absolute benefit of treatment with statins (simvastatin and pravastatin) is higher among the elderly. Effective treatment of 1000 elderly (aged<75 лет) пациентов в течение 6 лет предотвращает 45 смертельных случаев, 33 случая инфаркта миокарда, 32 эпизода нестабильной стенокардии, 33 процедуры реваскуляризации миокарда и 13 мозговых инсультов. Клинические испытания с участием больных старше 75 лет продолжаются. До получения результатов этих исследований вопросы профилактического назначения статинов больным с ИБС самого старшего возраста следует решать индивидуально.

In a large multicenter randomized trial PROSPER studied the effect of long-term use of pravastatin (40 mg / day) on the course and outcomes of coronary artery disease and the incidence of strokes in elderly people (age 70-82 years) with proven coronary artery disease or risk factors for its development. During 3.2 years of treatment, pravastatin reduced plasma LDL-C by 34% and reduced the combined risk of death from CAD and non-fatal MI by 19% (RR 0.81; 95% CI 0.69-0.94). The relative risk of stroke in the active treatment group did not change significantly (HR 1.03; 95% CI 0.81-1.31), while the overall relative risk of death from coronary artery disease and stroke, as well as non-fatal MI and non-fatal stroke, decreased by 15% (RR 0.85, 95% CI 0.74-0.97, p=0.0014). CHD mortality among those treated with pravastatin decreased by 24% (RR 0.76; 95% CI 0.58–0.99, p = 0.043). The study noted good tolerability of long-term use of pravastatin as part of combination therapy in the elderly - there were no cases of myopathy, liver dysfunction, and statistically significant memory impairment. Among those taking statins, there was a higher incidence (but not an increase in mortality!) of concomitant cancers (RR 1.25, 95% CI 1.04-1.51, p=0.02). The authors attribute this finding to a more thorough diagnostic examination of older people included in the study.

Thus, the PROSPER clinical trial at a high methodological level proved the efficacy and good tolerability of long-term use of pravastatin in elderly people with coronary artery disease, other cardiovascular diseases and cardiovascular risk factors.

Efficiency coronary bypass surgery and stenting of the coronary arteries in the elderly is comparable to the effectiveness of these interventions in younger patients, so age, in itself, is not an obstacle to invasive treatment. Restrictions may be caused by concomitant diseases. Considering that complications after bypass surgery are more common in the elderly, as well as symptomatic improvement as the most frequent desired goal of intervention in the elderly, it is necessary to take into account all comorbidities during preoperative preparation and, if possible, give preference to balloon coronary angioplasty and coronary artery stenting. .

Literature:

1. Aronow W.S. "Pharmacologic therapy of lipid disorders in the elderly" Am J Geriatr Cardiol, 2002; 11(4):247-256

2. Brookes L. “More antihypertensive treatment trials in the elderly: PROGRESS, Syst-Eur, VALUE, HYVET” Medscape coverage of 1st Joint Meeting of the International and European Societies of Hypertension

3. Jackson G. Stable angina in the elderly. Heart and metabolism, 2003;10:7-11

4. Rich M.W. "Heart failure in the elderly: strategies to optimize outpatient control and reduce hospitalizations". Am J Geriatr Cardiol, 2003 12(1):19-27

5 Sander G.E. "High blood pressure in the geriatric population: treatment consideration". Am J Geriatr Cardiol, 2002; 11;(3):223-232

6. The Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation and Treatment of High Blood Pressure. J.A.M.A., 2003; 289:2560-2572

7. Tresch D.D., Alla H.R. "Diagnosis and management of myocardial ischemia (angina) in the elderly patient" Am J Geriatr Cardiol, 2001 10(6):337-344

8. Belenkov Yu.N., Mareev V.Yu., Ageev F.T. "National guidelines for the diagnosis and treatment of chronic heart failure". "Heart failure", 2002, No. 6: 3-8

9. Lazebnik L.B., Komissarenko I.A., Huseynzade M.G., Preobrazhenskaya I.N. "Beta-blockers in geriatric practice" RMJ, 1999, vol. 7 No. 16: 66-70

10. Lazebnik L.B., Komissarenko I.A., Milyukova O.M. "Drug treatment of isolated systolic hypertension in the elderly" BC, 1998, v 6, No. 21: 25-29

11. Lazebnik L.B., Postnikova S.L. "Chronic heart failure in the elderly" BC, 1998, v 6, No. 21: 34-38

Question: What advice can you give to people who want to lose weight?

Answer: Hello, Ksenia Sergeevna! We talk about moderation all the time. I don't think people know what moderation is. You can eat foods that you really like, but eat a little less of them. It is not necessary to completely abandon them. Don't even think about giving them up! Better try to diversify your favorite dishes with others that are no less tasty and healthy.

Question: Doctor, have you ever violated your diet?

Answer: Hello Alexandra! I became a nutritionist not because I love learning about nutrients, but because I love to eat. Ironically, when I was writing an article about stomach shrinkage, my own stomach was getting bigger. I gained 9 kilos! My cholesterol level was 238! I realized that I was not following my own recommendations. I got a wake-up call after checking my cholesterol levels. In a month, I lost 5 kilos and my cholesterol level dropped to 168. A healthy plate of oatmeal, which I consumed every morning, played a key role. I added a handful of almonds, pistachios, walnuts, pecans, as well as a few cherries, raspberries, pomegranates to oatmeal. Every day I ate this healing food. In addition, I ate three pieces of oily fish a week. I also did physical activity for half an hour every day. What is very important - I did not refuse any of my favorite dishes. In fact, on the day I was going to check my cholesterol again, I stopped by my friend, who cooked a dinner of pork chop and various sauces. I was eating one chop and realized it might not be a good idea on the day I'm going to check my cholesterol. But the most interesting thing was that my cholesterol level dropped by 70 points. Imagine what my cholesterol level would have been if I hadn't eaten a pork chop before!

Question: What is your opinion on hormones and menopause? Do they slow down aging?

Answer: Good day! The concept of estrogen replacement therapy is based on this. The only difficulty lies in the side effects of this concept, which potentially increase women's risk of developing heart disease. There are estrogen-rich foods that can help keep skin nice and soft. Soy is a good source of these substances. Beans and legumes are generally high in phytoestrogens. Flax is also a source of these substances. The main thing is that these foods should be consumed throughout your life, and not wait until you are 50 years old. Start eating these foods from childhood, but in moderation. Many people believe that the more soy or other foods they eat, the healthier they will be. In Japanese culture, for example, soy is not a staple food. A handful of green soybeans and a small amount of tofu will suffice. You don't have to eat a whole kilo of tofu. A lot doesn't mean it's useful.

Question: How strongly do genetic data influence the aging process? Can you do something to control your genes?

O.V. Korkushko.

SE "Institute of Gerontology of the Academy of Medical Sciences of Ukraine", Kyiv.

Interest in the study of the age-related features of the cardiovascular system - the structure, function and regulation of its activity - is primarily due to the fact that developing age-related changes in the circulatory system, not being primary in the genesis of aging, largely determine the nature and rate of aging of the body. Firstly, they significantly limit the adaptive capabilities of an aging organism, and secondly, they create the prerequisites for the development of pathology, which is the main cause of human death: atherosclerosis, arterial hypertension, coronary heart disease and brain.

The parameters of age-related changes in the cardiovascular system presented below are based on the study of physiologically aging people of various ages specially selected at the Institute of Gerontology of the Academy of Medical Sciences.

Vascular system. The main changes that occur in large arterial trunks are sclerotic thickening of the inner membrane (intima), atrophy of the muscle layer, and a decrease in elasticity. Physiological sclerosis of the arteries decreases towards the periphery. Ceteris paribus, changes in the vascular system are more pronounced in the lower extremities than in the upper ones. Morphological studies are confirmed by clinical observations. When considering age-related changes in the speed of propagation of a pulse wave in various parts of large arterial vessels, it was noted that with age there is a natural increase in it, an increase in the modulus of elasticity. Therefore, an increase in the speed of propagation of the pulse wave, which exceeds age standards, is an important diagnostic sign of atherosclerosis. Age-related changes in arterial vessels cause their insufficient ability not only to expand, but also to narrow. All this, along with the altered regulation of vascular tone in general, disrupts the adaptive capacity of the circulatory apparatus. First of all, and to a greater extent, the large arterial vessels of the systemic circulation, especially the aorta, change, and only at older ages does the elasticity of the pulmonary artery and its large trunks decrease. Along with the increase in stiffness of arterial vessels, loss of elasticity, there is an increase in the volume and capacity of the arterial elastic reservoir, especially the aorta, which to a certain extent compensates for the impaired functions of the elastic reservoir. However, in later life, the increase in volume does not go hand in hand with a decrease in elasticity. This violates the adaptive capacity of both the systemic and pulmonary circulation.

A significant contribution to the study of the elastic-viscous properties of arterial vessels was made by the rheography of peripheral vessels, rheoencephalography. It has been established that with age, the elastic properties of peripheral arterial vessels and cerebral vessels decrease, as evidenced by a change in the shape of the rheogram curve and its temporal indicators (decrease in the amplitude of the rheographic wave, its slow rise, a rounded, often arched top, smoothness of the dicrotic wave, an increase in the propagation velocity pulse wave, etc.). Along with large arterial vessels, the capillary network is also subject to age-related restructuring. Pre- and postcapillaries, the capillaries themselves are characterized by the phenomena of fibrosis and hyaline degeneration, which can lead to complete obliteration of their lumen. With increasing age, the number of functioning capillaries per unit of tissue decreases, and the capillary reserve also significantly decreases. At the same time, the changes are more pronounced in the lower extremities. Often there are areas devoid of capillary loops - fields of "baldness". The considered sign is associated with complete obliteration of capillaries, which is confirmed by histological studies of the skin. There are similar changes in the capillaries under microscopy of the conjunctiva of the eyeball. With aging, the shape of the capillaries changes. They become twisted, elongated. The spastic form of capillary loops predominates with narrowing of the arterial and venous branches, and the spastic-atonic form with narrowing of the arterial and expansion of the venous branches. These changes in the capillaries, along with age-related changes in the rheological properties of the blood, cause a decrease in capillary circulation and, thereby, oxygen supply to tissues. On the one hand, the slowing down of capillary blood flow, on the other hand, the lengthening of the intercapillary distance, as a result of a decrease in the number of functioning capillaries, and a thickening of the basement membrane due to its multilayer nature (electron microscopy data), significantly worsen the conditions for oxygen diffusion into the tissue.

Conducted jointly with K.G. Sarkisov, A.S. Stupina (1978), studies of the state of capillaries in skin biopsy specimens using electron microscopy showed that with age, thickening of the basement membrane of capillaries, collagenization of fibrils, a decrease in pore diameter, and a decrease in pinocytosis activity occur. These changes lead to a decrease in the intensity of transcapillary exchange. In this regard, we can agree with the statements of P. Bastai (1955) and M. Burger (1960), who put forward changes in the microcirculation system as one of the causes of aging. We have shown a significant decrease in renal circulation with aging, which is directly related to a decrease in microvascularization. Endoscopic studies of the gastric mucosa and biopsy specimens revealed a decrease in the number of microvessels. A significant decrease in human aging was also found in muscle blood flow, both at rest (MCP) and maximum muscle blood flow (MMC) when performing dosed physical activity. The study of muscle blood flow was carried out by the method of local clearance of Xe133 on the Xenon radiometric unit. Such a decrease in MMC indicates a significant limitation of the functionality of the microcirculatory system in skeletal muscles, which is one of the reasons for the limitation of muscle performance. Considering the reasons for the decrease in muscle blood flow during aging, the following circumstances should be taken into account: age-related changes in central hemodynamics play a certain role - a decrease in cardiac output, processes of physiological arteriosclerosis of arterial vessels, deterioration of the rheological properties of blood. However, age-related changes in the microcirculatory link play a leading role in this phenomenon: obliteration of arterioles and a decrease in muscle capillarization.

With age, starting from the fourth decade, endothelial dysfunction increases, both in large arterial vessels and at the level of the microcirculatory vascular bed. A decrease in endothelial function significantly affects changes in intravascular hemostasis, increasing the thrombogenic potential of the blood. These changes, along with age-related slowing of blood flow, predispose to the development of intravascular thrombosis, the formation of atherosclerotic plaque.

With age, there is a slight increase in blood pressure, mostly systolic, final and average dynamic. The lateral, shock and pulse pressure also increases. An increase in blood pressure is mainly associated with age-related changes in the vascular system - loss of elasticity of large arterial trunks, an increase in peripheral vascular resistance. The absence of a significant increase in blood pressure, primarily systolic, is largely due to the fact that with aging, along with the loss of elasticity of large arterial trunks, especially the aorta, its volume increases and cardiac output decreases. In old age, the coordinated relationship between the various parts of the circulatory system is disrupted, which manifests itself as an inadequate response of arterioles to changes in the volume of circulation. Expansion of the venous bed, decrease in tone, elasticity of the venous wall are the determining factors in the decrease in venous blood pressure with age.

The progressive decrease in the lumen of small peripheral arteries, on the one hand, reduces blood circulation in the tissues, and on the other hand, causes an increase in peripheral vascular resistance. However, it should be noted that the same type of changes in total peripheral vascular resistance hides its different topography and shifts in regional tone. So, in elderly and old people, the total renal vascular resistance of the blood increases to a greater extent than the total peripheral vascular resistance.

As a result of the loss of elasticity of large arterial trunks, the activity of the heart becomes less economical with age. This is confirmed by the following facts: firstly, in the elderly and old compared to young people, there is an increased energy consumption by the left ventricle of the heart per 1 liter of cardiac output (MOV); secondly, with age, the IOC significantly decreases, however, the work performed by the left ventricle in 1 min practically does not change ((61.78±0.98) J at 20–40 years and (59.82±3.92) J at 90–99 years old); thirdly, the ratio between the total elastic resistance (Eo) and peripheral vascular resistance (W) changes. According to the literature, the indicator (Eo/W) characterizes the ratio between the amount of energy that is expended by the heart directly on the movement of blood through the vessels, and the amount that is accumulated by the walls of the vessels. With age, this ratio naturally increases, averaging 0.650 ± 0.075 for 20–40 years old; for the seventh decade - 0.77±0.06; for the eighth - 0.86±0.05; for the ninth – 0.930±0.044; for the tenth - 1.090±0.075 (Р<0,01).

Thus, the presented facts show that due to age-related changes in large arterial vessels, their elasticity is lost and thus conditions are created under which the heart expends more energy to move blood. These changes are especially pronounced in the systemic circulation and cause the development of compensatory hypertrophy of the left ventricle and an increase in heart mass.

Reflexes on the cardiovascular system and the state of the hemodynamic center. Studies show that conditioned reflex influences on the cardiovascular system in the elderly and old people are weakened with aging - they are more slowly fixed and quickly fade away. So, to develop a conditioned reflex to the vessels (based on thermal stimuli), young people need 3–4 combinations, and old people need 9–12 combinations. The weakening of conditioned reflex influences is also expressed in the fact that in older people shifts in vascular tone, arterial pressure and the rhythm of heart contractions are much less pronounced when warning them of upcoming work.

With aging, unconditioned reflexes to blood circulation also change.

A simple vegetative-vascular test, which allows to some extent to judge the functional ability of capillaries to respond to mechanical stimuli, is the definition of dermographism. Using a dosed spring dermograph with a pressure gradation from 100 to 400 g, it was shown that when 100 g of force was applied to the skin in young people (18–25 years old), the latent period of the reaction was (6.80 ± 0.39) s, in persons 60–69 years old - (8.88±0.47) s, 70–79 years old - (9.77±0.48) s, 90 years and older - (12.5±0.51) s. With an increase in the applied load, the duration of the latent period was reduced, but in elderly and old people it was still significantly longer than in young people under the same conditions.

The inertia of vascular reactions (prolongation of the latent period, the time of the entire reaction, the recovery period) in older people is also observed in other functional tests. When studying vascular reactivity in response to thermal stimuli (heat, cold), about half of all those examined over the age of 60 show an inadequate reaction. Moreover, changes in the state of vascular tone and blood pressure in the case of both adequate and inadequate responses are characterized by a protracted recovery period. This is evidenced by the data of digital photoplethysmography. In response to the use of thermal stimuli, in most of the examined persons over 60 years of age, plethysmograms were characterized by an inert type of development - an extended latent period, slow development of the reaction, and a protracted recovery period. The conducted studies of the microcirculation of the nail fold of the hand also showed that the response in the elderly and old people when applying a thermal stimulus arose later, slowly increased and was significantly extended in time. The same pattern was found in the study of the functional state of peripheral vessels according to rheographic studies using pharmacological tests.

Adrenergic regulation. Clinical and experimental studies have shown that sympathetic nerve influences on the cardiovascular system weaken with age. Along with the weakening of sympathetic influences on the cardiovascular system, with age there is an increase in its sensitivity to catecholamines (norepinephrine, adrenaline). Observations show that at lower doses of injected humoral substances (adrenaline, norepinephrine), the elderly and old people experience pronounced changes in the cardiovascular system - vascular tone, blood pressure, hemodynamics. In elderly and old people, in contrast to young people, changes in skin microcirculation were manifested with the introduction of catecholamines in low concentrations. An increase in sensitivity to humoral substances is also evidenced by the fact that with age, when an irritant is applied, the latent period of the occurrence of a vascular reaction is reduced, while with reflex stimulation (cold and heat), the response is significantly delayed. However, the reactivity of the cardiovascular system decreases with age. This feature was found under the influence of reflex and humoral stimuli, as well as physical activity.

Cholinergic regulation. In the process of aging, the influence of the vagus nerve on the cardiovascular system is weakened, but its sensitivity to the cholinergic mediator, acetylcholine, increases. When conducting Ashner-Dagnini, Cermak, Valsalva and other tests in elderly and old people, which increase the tone of the vagus nerve, there was no significant slowdown in the heart rate, as was the case in young people. Moreover, the reaction often had a paradoxical character and was even absent.

In the studies of V.V. Bezrukov (1980) found that in old rabbits, changes in blood pressure develop with the introduction of lower doses of acetylcholine ((1.4±0.5) µg/kg) than in adults ((9.4±2.7) µg/kg). kg). The same regularity was established by us in the study of people. It was noted that a slowdown in the heart rate, a decrease in blood pressure, minute volume, and the power of contractions of the left ventricle in 60-69-year-old people develop with the introduction of 0.025 g of acetylcholine, in young people (20-29 years old) - 0.075 g. Increased sensitivity to acetylcholine found in the capillaries. These observations confirm that sensitivity to the mediator of the parasympathetic nervous system, acetylcholine, increases with age.

The weakening of the nervous influences on the cardiovascular system is largely associated with destructive changes in the nervous apparatus and with shifts in the synthesis of acetylcholine.

Hormonal regulation. It can be assumed that age-related changes in secretion, hormone metabolism, and the state of cellular receptors largely determine changes in metabolic processes and the function of the cardiovascular system in old age. A decrease in the effective concentration of anabolic-type hormones (insulin, sex hormones) contributes to the development of insufficiency in providing functions in old age. This can largely explain the fact that myocardial hypertrophy during aortic coarctation in old animals is less pronounced and heart failure develops faster [Frolkis V.V. et al., 1977]. A similar dependence is found in the elderly and old people (less pronounced left ventricular hypertrophy) with arterial hypertension. Vasopressin is of great importance in changing blood circulation and vascular tone in old age. We have shown that the concentration of this hormone increases with age, and the sensitivity of the heart and blood vessels to it increases.

With the introduction of the same dose of vasopressin in older people, in comparison with young people, more pronounced changes in hemodynamics were observed, and the reaction was of a protracted nature. Particularly distinct age differences were obtained in the study of skin microcirculation. Thus, even small doses of administered pituitrin caused changes in capillary circulation - vasoconstriction. In this case, the reaction occurred much earlier and was longer. An increase in the body's sensitivity to vasopressin is also evidenced by the fact that in old animals, at lower doses of the hormone, it is possible to cause experimental hypertension and coronary insufficiency [Frolkis VV, 1976, 1996]. It was shown that the concentration of vasopressin increases in the blood of patients with coronary heart disease and arterial hypertension. It is assumed that all these changes in the content and action of vasopressin play an important role in the development of circulatory pathology in old age. It was also noted that with age, the sensitivity of the cardiovascular system to many other humoral substances, in particular to angiotensin and histamine, increases.

Reflexes from vessels and heart. As you know, the adaptation of the cardiovascular system to the constantly changing conditions of the body's activity is largely achieved due to feedback from the receptors of the heart and blood vessels. At the same time, it has been established that with aging, reflexes from the baroreceptors of the carotid sinus and aortic arch are weakened. All this leads to the fact that in old age the range of adaptation possibilities of the cardiovascular system is reduced, the perfection of the mechanisms of regulation of blood pressure is reduced.

Weakening of reflexes from vascular baroreceptors is associated with a change in the elastic-viscous properties of the vascular wall, changes in the nerve endings themselves, and shifts in the hemodynamic center. According to modern concepts, the reaction of the cardiovascular system in carotid sinus reflexes is also associated with changes in the activity of the sympathetic nervous system. Therefore, the observed weakening of sympathetic influences with age contributes to the fact that in old age the latent period of development of reflex changes in hemodynamics lengthens and their severity decreases. Experimental data also indicate that reflexes from the interoreceptors of a number of other vascular areas are weakened in old animals (Frolkis VV, 1980, 1996). In particular, in old rabbits, reflexes from the baroreceptors of the heart, recorded during atrial stretch, are weakened.

In turn, the decrease in depressant influences from the reflexogenic zones of the heart, arterial vessels (carotid sinus and aortic arch) during aging can cause the development of disinhibition hypertension, which is so common in old age.

Regulation of the coronary circulation. The studies carried out are mainly experimental in nature. This is understandable, since the study of the characteristics of the coronary circulation in humans encounters great methodological difficulties. In this regard, of particular interest are the data of V. G. Shevchuk (1980), who showed that with age, the influence of the vagus nerve on the coronary circulation weakens. The same relationship was established in relation to the sympathetic nervous system. Thus, the thresholds of stimulation by electric current of the sympathetic and vagus nerves, causing shifts (changes) in the coronary circulation, were higher in old animals than in young ones. Along with this, with aging, the sensitivity of coronary vessels to humoral substances increases - adrenaline, norepinephrine, acetylcholine. Often in old animals a paradoxical reaction was observed with the introduction of catecholamines, acetylcholine.

The presented data, to a certain extent, reveal one of the mechanisms of such a frequent manifestation of coronary insufficiency in the elderly and old people. Thus, the weakening of nerve influences on the coronary vessels and the increase in their sensitivity to mediators and hormones during aging, the presence of paradoxical reactions to catecholamines can cause the development of coronary insufficiency even in mild stressful situations.

Regulation of cerebral circulation. Numerous studies have shown that the level of cerebral blood flow is highly stable in relation to shifts in general hemodynamics. However, in our studies it was shown that in elderly and old people, along with a significant decrease in the adaptive reactions of hemodynamics, the mechanisms of autoregulation of cerebral circulation are disturbed. Thus, in response to inhalation of pure oxygen, the most pronounced reaction occurred in young people (in young people, cerebral blood flow decreased by (16.9 ± 1.3) ml / 100 g min, while in the group of middle-aged people this decrease was by (9.1 ± 0.9), and in the elderly - by (7.0 ± 0.5) ml / 100 g min).

It has been established that in elderly and old people, inhalation of 5% CO2 causes a smaller increase in cerebral blood flow than in young people (40 and 70%, respectively). Such features, it should be assumed, are associated both with morphological changes in blood vessels, leading to the loss of their elasticity, and with a violation of the mechanisms of autoregulation.

So, with aging, changes occur in all parts of the neurohumoral regulation of the cardiovascular system. Along with the manifestation of extinction and violations of regulatory influences, important adaptive changes are noted - an increase in the sensitivity of the heart and blood vessels to humoral factors and mediators in conditions of destruction of nerve endings, as well as a weakening of the synthesis of mediators. In other words, with age in the regulation of the cardiovascular system, the role of physiologically younger regulatory mechanisms - nervous - is weakened and the significance of older, but at the same time more inert - humoral, increases. Common features that are naturally traced during aging are the delayed achievement of the maximum reaction and a protracted recovery period when the cardiovascular system is out of balance. With age, the threshold of blood supply to various organs and systems, and, in particular, the heart and brain, decreases, as a result of which less pronounced shifts in hemodynamics with altered neurohumoral regulation can cause frequent disruption of their activity. This position is well illustrated by the facts obtained in the process of studying the cardiovascular system in various conditions, which were characterized by a drop in blood pressure.

In connection with the foregoing, the notion that in the process of aging the human cardiovascular system undergoes a number of structural and functional changes, which, in general, significantly limit the range of its functional capabilities, should be considered sufficiently justified, and thus prerequisites are created for faster development of pathology.

Ukrcardio

Age-related changes in the vessels and heart to a large extent limit their adaptive capabilities and create prerequisites for the development of diseases.

CHANGES IN VESSELS

The structure of the vascular wall changes with age in each person. The muscle layer of each vessel gradually atrophies and decreases, its elasticity is lost and sclerotic seals of the inner wall appear. This greatly limits the ability of blood vessels to expand and narrow, which is already a pathology. First of all, large arterial trunks, especially the aorta, suffer. In elderly and old people, the number of active capillaries per unit area is significantly reduced. Tissues and organs cease to receive the amount of nutrients and oxygen they need, and this leads to their starvation and the development of various diseases.

With age, in each person, small vessels are more and more “clogged” with lime deposits, and peripheral vascular resistance increases. This leads to some increase in blood pressure.

But the development of hypertension is largely hampered by the fact that with a decrease in the tone of the muscle wall of large vessels, the lumen of the venous bed expands. This leads to a decrease in the minute volume of the heart (minute volume - the amount of blood ejected by the heart in one minute) and to an active redistribution of the peripheral circulation. The coronary and cardiac circulations are usually almost unaffected by the decrease in cardiac output, while the renal and hepatic circulations are greatly reduced.

REDUCED CONTRACTILITY OF THE HEART MUSCLE

The older a person becomes, the more muscle fibers of the heart muscle atrophy. The so-called "senile heart" develops. There is a progressive sclerosis of the myocardium, and in place of the atrophied muscle fibers of the heart tissue, fibers of non-working connective tissue develop. The strength of heart contractions gradually decreases, there is an ever-increasing violation of metabolic processes, which creates conditions for energy-dynamic insufficiency of the heart in conditions of intense activity.

In addition, in old age, conditioned and unconditioned reflexes of the regulation of blood circulation are weakened, and the inertness of vascular reactions is increasingly revealed. Studies have shown that with aging, the effects on the cardiovascular system of various brain structures change. In turn, the feedback also changes: the reflexes coming from the baroreceptors of large vessels are weakened. This leads to dysregulation of blood pressure.

As a result of all of the above processes, the physical performance of the heart decreases with age. This leads to a limitation of the range of reserve capabilities of the body and to a decrease in the efficiency of its work.

NUTRITION AND CARDIOVASCULAR DISEASE

There is a wonderful saying in medicine: "Man digs his own grave with his teeth." The meaning of this saying is that the malnutrition of the vast majority of the population leads to the development of most human diseases and premature aging.

In the human body, all systems and organs are important, but only with a well-coordinated system of their work can we talk about health. Each cell of our body is closely connected with millions of other cells of the body by invisible threads, and the work of other cells depends on how it works. But any cell remains alive as long as the processes of assimilation (assimilation, nutrition) and dissimilation (removal of toxins) take place in it. Similarly, the normal functioning of each cell depends on good nutrition and timely cleansing. If the nutrition of the cell is disturbed, its functions are violated. If the nutrition of a group of cells is disrupted, then the activity of an organ or system is disrupted.

In a calm state, a person needs from 1500 to 2000 kilocalories per day for normal life. When performing physical or mental work, the number of kilocalories should be increased to 3-4 thousand. A person receives these kilocalories (or energy) when proteins, fats and carbohydrates are burned in his body. The most energy-rich are fats, which, when burned, provide as much energy as proteins and carbohydrates combined.

During the autopsy of children who died from various diseases, it was found that all children without exception (100 percent) already had sclerotic changes in their vessels. What does it say? First of all, about malnutrition from early childhood. Loving parents, grandparents, relatives and friends have been trying since childhood to stuff a child with cake, ice cream, Snickers or chocolate.

And children grow quickly, quickly gain weight and gain excess weight, which leads to excessive body fat and disruption of the cardiovascular system. With age, fat deposits in tissues and muscles grow, the amount of cholesterol in the blood increases - early atherosclerosis occurs. And it is not surprising that coronary vessels are often detected already at the age of 20.

Many obese people say that their fullness is "hereditary". But that doesn't happen. Hereditary is not completeness, but gluttony. If the family is used to eating 5-6 times a day without any system and order, if the father, mother and grandmother constantly abuse fatty foods, then the children will follow in their footsteps. Parents were complete people, the same will be their children. That's heredity for you!

Our distant ancestors knew how to limit themselves in food, moved and worked more. Therefore, ancient physicians hardly heard anything about early atherosclerosis.

A few words about posts. The benefits of fasting have been mentioned in the Bible. In the past, our grandparents followed the Bible very closely and fasted almost weekly.

And Great Lent, a great cleansing from all winter overeating, how much benefit it brought to people! Nowadays, people have forgotten about fasting and joined in overeating. This is one of the important reasons for the early appearance of atherosclerosis and coronary heart disease.

An important drawback of modern nutrition is its monotony. What is the main diet of a city dweller? These are meat, boiled and fried, canned food, bread, sweet pastries, sugar, animal fats, potatoes. Fruits and vegetables are in one of the last places. But this is exactly what not to do!

How does official medicine advise modern man to eat?

A.A. Pokrovsky and a group of co-authors recommend limiting the calorie content of food at the expense of carbohydrates, which are well and quickly absorbed, and animal fats rich in cholesterol. They recommend limiting salt, butter, margarine in the diet, and excluding foods rich in cholesterol (smoked meats, lard, canned meat, etc.) from the diet. Animal oils are recommended to be replaced with vegetable oils. The diet of each person should contain a sufficient amount of berries, vegetables, fruits. Food should be fractional (5-6 times a day and little by little). Once a week, a fasting day is required.

With hypertension, atherosclerosis and coronary heart disease, the following products are not recommended and even prohibited: strong meat broths, fats (beef, pork, mutton), internal organs of animals, caviar, brains, lard.

From sweet dishes it is necessary to exclude: various creams, cakes, muffins.

Pickles, spicy and sour dishes, smoked meats, herring are generally contraindicated for sick people and are not recommended for healthy people.

Cocoa, coffee, chocolate, sugar, alcoholic drinks, beer, ice cream - all these foods will also bring you nothing but trouble. These troubles and health problems will not be revealed immediately, but with age.

Bread and flour products	Yesterday's bread, with minimal or no salt, from rye flour or wholemeal flour, bran bread, crackers, biscuits (not made from butter flour)
Meat dishes and dishes	Lean meats. Do not use fried poultry, but only take it boiled or baked in the oven. (with the exception of the internal organs and brain of animals)
	Fruit, cereal, vegetarian, dairy
	In food, use only low-fat varieties in boiled or baked form.
	Limit to 2-3 per week. It is better to eat in the form of steam omelettes.
Milk and dairy	Apply both in its natural form and products in the form of milk porridge, kefir and yogurt. Cottage cheese should only be used fresh.
	Use only vegetable oils for cooking and salads Butter can be used for cooking
	Non-spicy and unsalted cheeses, low-fat sausage (doctor's type), salads, low-fat ham
	Any fruit and vegetable juices, kvass, decoction of wild rose, hawthorn, mint. Limit carbonated drinks
Seafood	All types of brown algae, sea scallops, shrimps, squids, mussels, seaweed dishes

Patients with hypertension and atherosclerosis in chronic heart failure are recommended foods with a high content of potassium: dried apricots, currants, dried grapes, apricots, prunes, bananas, apricots, parsley, celery, dill (especially dill seed). In this case, you need to sharply limit the intake of salt, salty and smoked foods, limit the amount of fluid you drink.

ANCIENT MEDICINE ABOUT DISEASES OF THE CARDIOVASCULAR SYSTEM

MONASTERY RECIPES

- Prepare collection:

Valerian root

motherwort herb

lavender flowers

fennel fruit

Cumin fruits

Just take 3 tablespoons, chop, mix. Pour 1 tablespoon of the collection with a glass of boiling water, leave for 1 hour, strain. Drink 1 tablespoon three times a day before meals with palpitations and cardiac neuroses.

- Prepare collection:

Mountain arnica flowers -20 g

Black elderberry flowers -20 g

Rosemary leaves -30 g

All mix, grind. Pour 1 tablespoon of the collection with 300 ml of boiling water, leave for 1 hour, strain. Drink 1 tablespoon three times a day for myocardial dystrophy.

At ATHEROSCLEROSIS you can prepare the following fees.

Rue herb

Cumin fruits - 2 tbsp. spoons

Periwinkle leaves

The fruits of ammi tooth -4 tbsp. spoons

Valerian root - 3 tablespoons

Hawthorn flowers -3 tbsp. spoons

White mistletoe grass - 6 tbsp. spoons

Grind everything, mix. Pour 1 tablespoon of the collection with 300 ml of boiling water, boil in a water bath for 15 minutes, cool at room temperature for an hour, strain. Drink 1 tablespoon three times a day before meals.

Thyme herb - 30 g

Rue grass - 30 g

Melissa leaves -40 g

Melissa leaves - 20 g

Lily of the valley flowers -10 g

Rue grass - 30 g

Potentilla grass goose - 30 g

Preparation and application as in the previous recipe.

White mistletoe grass -4 tbsp. spoons

Yarrow herb -4 tbsp. spoons

Cystoseira herb - 6 tbsp. spoons

Fucus grass - 6 tbsp. spoons

All mix, grind. Pour 1 tablespoon of the collection with 300 ml of boiling water, leave for 2 hours, strain. Drink 1 tablespoon three times a day 30 minutes before meals ATHEROSCLEROSIS, ACCOMPANYING OBESITY.

At HYPERTENSION disease, you can prepare the following fees.

Peppermint leaves - 6 tbsp. spoons

Valerian roots - 6 tbsp. spoons

Chamomile flowers -8 tbsp. spoons

Watch leaves - 8 tbsp. spoons

Cumin fruits - 10 tbsp. spoons

3 tablespoons of the collection pour 500 ml of boiling water, insist overnight in a warm place, strain. Drink 1/2 cup three times a day.

herb oregano

Linden flowers

Raspberries

plantain leaves

Leaves coltsfoot

birch leaves

Mordovnik fruits

Liquorice root

Just take 1 tablespoon, mix, chop. Pour 2 tablespoons of the collection into 500 ml of boiling water, boil in a water bath for 15 minutes, insist overnight in a warm place. Strain and drink 1 tablespoon three to four times a day before meals.

Melissa leaves

Valerian roots - 4 tbsp. spoons

Hop cones - 1 tbsp. a spoon

Pour 2 teaspoons of the collection with a glass of boiling water, leave for 6 hours in a warm place, strain. Take 1 tablespoon three times daily before meals.

Red clover flowers. 1 tablespoon of dried flowers pour 300 ml of water, leave for 1 hour, strain. Drink 100 ml three times a day.

hawthorn flowers

hawthorn fruit

mistletoe grass

garlic bulb

Horsetail herb - 3 tbsp. spoons

Arnica flowers - 1 tbsp. a spoon

All mix, grind. Pour 1 tablespoon of the mixture with 300 ml of boiling water, leave for 1 hour, strain. Drink 1/3 cup three times a day before meals.

cornflower grass

Dog-rose fruit

Hawthorn fruits and flowers

Cudweed grass

motherwort herb

Just take 1 tablespoon, chop, mix. Pour the collection of 500 ml of boiling water, leave for 8 hours, strain. Drink during the day.

At HYPOTONIA monastic herbalists recommend:

Ephedra herb - 2 tbsp. spoons

Horse chestnut leaves - 2 tbsp. spoons

Hawthorn fruits -2 tbsp. spoons

All mix, grind. Pour 1 tablespoon of the mixture with 300 ml of boiling water, leave for 1 hour, strain. Drink 1 tablespoon 3-4 times a day.

Aralia rhizome

Leuzea rhizome

Dog-rose fruit

Hawthorn fruits - 3 tbsp. spoons

Grass of succession

calendula flowers

plantain leaves

The fruits of the chokeberry - 2 tbsp. spoons 3 tablespoons of the collection pour 500 ml of boiling water. Insist in a thermos overnight, strain. Drink 150 ml three times a day.

Yarrow herb

Grass mountaineer bird

Rue leaves - 3 tbsp. spoons

Goat willow grass - 5 tbsp. spoons

Horse chestnut bark -2 tbsp. spoons

All mix, grind. Pour 1 tablespoon of the mixture with a glass of boiling water, insist in a thermos for 6 hours, strain. Take three times a day, 200 ml.

From prenatal development to old age, age-related features of the cardiovascular system are observed. Every year there are new changes that ensure the normal functioning of the body.

The aging program is embedded in the human genetic apparatus, which is why this process is an invariable biological law. According to gerontologists, the real life expectancy is 110-120 years, but this moment depends only on 25-30% of inherited genes, everything else is the influence of the environment, which affects the fetus in the womb. After birth, you can add on environmental and social conditions, health status, etc.

If you add everything together, not everyone can live more than a century, and there are reasons for that. Today we will consider the age-related features of the cardiovascular system, since the heart with numerous vessels is the “engine” of a person, and life is simply impossible without its contractions.

How does the fetal cardiovascular system develop in the womb?

Pregnancy is a physiological period during which a new life begins to form in a woman's body.

All intrauterine development can be divided into two periods:

embryonic– up to 8 weeks (embryo);
fetal- from 9 weeks to childbirth (fetus).

The heart of the future man begins to develop as early as the second week after the fertilization of the egg by the spermatozoon in the form of two independent heart germs, which gradually merge into one, forming a semblance of a fish heart. This tube grows rapidly and gradually moves down into the chest cavity, where it narrows and bends, taking on a certain shape.

At week 4, a constriction is formed, which divides the organ into two sections:

arterial;
venous.

At week 5, a septum appears, with the help of which the right and left atrium appears. It is at this time that the first pulsation of a single-chamber heart begins. At week 6, heart contractions become more intense and clearer.

And by the 9th week of development, the baby has a full-fledged four-chamber human heart, valves and vessels for moving blood in two directions. The complete formation of the heart ends at week 22, then only the muscle volume increases and the vascular network expands.

You need to understand that such a structure of the cardiovascular system implies some distinctive features:

Prenatal development is characterized by the functioning of the "mother-placenta-child" system. Oxygen, nutrients, as well as toxic substances (drugs, alcohol breakdown products, etc.) enter through the umbilical vessels.
Only 3 channels work - an open oval ring, botalla (arterial) and arantia (venous) duct. This anatomy creates parallel blood flow as blood flows from the right and left ventricles to the aorta and then through the systemic circulation.
Arterial blood from the mother to the fetus goes through the umbilical vein, and saturated with carbon dioxide and metabolic products returns to the placenta through 2 umbilical arteries. Thus, we can conclude that the fetus is supplied with mixed blood, when, after birth, arterial blood flows strictly through the arteries, and venous blood through the veins.
The pulmonary circulation is open, but a feature of hematopoiesis is the fact that oxygen is not wasted on the lungs, which in fetal development do not perform the function of gas exchange. Although a small amount of blood is taken, this is due to the high resistance created by non-functioning alveoli (respiratory structures).
The liver receives about half of the total blood delivered to the baby. Only this organ boasts the most oxygenated blood (about 80%), while others feed on mixed blood.
It is also a feature that the blood contains fetal hemoglobin, which has a better ability to bind with oxygen. This fact is connected with the special sensitivity of the fetus to hypoxia.

It is this structure that allows the baby to receive vital oxygen with nutrients from the mother. The development of the baby depends on how well a pregnant woman eats and leads a healthy lifestyle, and the price, mind you, is very high.

Life after birth: features in newborns

Termination of the connection between the fetus and the mother begins immediately with the birth of the baby and as soon as the doctor bandages the umbilical cord.

With the first cry of the baby, the lungs open and the alveoli begin to function, reducing resistance in the pulmonary circulation by almost 5 times. In this regard, the need for the arterial duct stops, as it was necessary before.
The heart of a newborn baby is relatively large and equals approximately 0.8% of body weight.
The mass of the left ventricle is greater than the mass of the right.
A full circle of blood circulation is carried out in 12 seconds, and blood pressure averages 75 mm. rt. Art.
The myocardium of the born baby is presented in the form of undifferentiated syncytium. Muscle fibers are thin, do not have transverse striation and contain a large number of nuclei. Elastic and connective tissue is not developed.
From the moment the pulmonary circulation is launched, active substances are released that provide vasodilatation. Aortic pressure significantly exceeds compared with the pulmonary trunk. Also, features of the neonatal cardiovascular system include closure of bypass shunts and overgrowth of the annulus ovale.
After birth, the subpapillary venous plexuses are well developed and located superficially. The walls of the vessels are thin, elastic and muscle fibers are poorly developed in them.

Attention: the cardiovascular system has been improving for a long time and completes its full formation in adolescence.

What changes are typical for children and adolescents

The most important function of the circulatory organs is to maintain a constancy of the body's environment, the delivery of oxygen and nutrients to all tissues and organs, the excretion and removal of metabolic products.

All this happens in close interaction with the digestive, respiratory, urinary, vegetative, central, endocrine systems, etc. Growth and structural changes in the cardiovascular system are especially active in the first year of life.

If we talk about the features in childhood, preschool and adolescence, we can distinguish the following distinctive features:

By 6 months, the mass of the heart is 0.4%, and by 3 years and beyond, about 0.5%. The volume and mass of the heart increases most intensively in the first years of life, as well as in adolescence. In addition, it happens unevenly. Up to two years, the atria grow more intensively, from 2 to 10 years, the entire muscular organ as a whole.
After 10 years, the ventricles increase. The left one is also growing faster than the right one. Speaking about the percentage ratio of the walls of the left and right ventricles, the following figures can be noted: in a newborn - 1.4: 1, at 4 months of life - 2: 1, at 15 years old - 2.76: 1.
All periods of growing up in boys, the size of the heart is larger, with the exception of from 13 to 15 years old, when girls begin to grow faster.
Up to 6 years, the shape of the heart is more rounded, and after 6 it acquires an oval, characteristic of adults.
Up to 2-3 years, the heart is located in a horizontal position on an elevated diaphragm. By the age of 3-4, due to an increase in the diaphragm and its lower standing, the heart muscle acquires an oblique position with a simultaneous flip around the long axis and the location of the left ventricle forward.
Up to 2 years, the coronary vessels are located according to the loose type, from 2 years to 6 they are distributed according to the mixed type, and after 6 years the type is already main, characteristic of adults. The thickness and lumen of the main vessels increase, and the peripheral branches are reduced.
In the first two years of a baby's life, differentiation and intensive growth of the myocardium occurs. A transverse striation appears, muscle fibers begin to thicken, a subendocardial layer and septal septa are formed. From 6 to 10 years of age, the gradual improvement of the myocardium continues, and as a result, the histological structure becomes identical to adults.
Up to 3-4 years, the instruction for the regulation of cardiac activity involves the innervation of the nervous sympathetic system, which is associated with physiological tachycardia in babies of the first years of life. By the age of 14-15, the development of the conductor system ends.
Young children have a relatively wide lumen of the vessels (in adults, 2 times already). Arterial walls are more elastic and that is why the rate of blood circulation, peripheral resistance and blood pressure are lower. Veins and arteries grow unevenly and do not match the growth of the heart.
Capillaries in children are well developed, the shape is irregular, tortuous and short. With age, they settle deeper, elongate and take on a hairpin shape. The permeability of the walls is much higher.
By the age of 14, a full circle of blood circulation is 18.5 seconds.

The heart rate at rest will be equal to the following figures:

Heart rate according to age. You can learn more about the age-related characteristics of the cardiovascular system in children from the video in this article.

Cardiovascular system in adults and the elderly

Age classification according to WHO is equal to the following data:

Young age from 18 to 29 years.
Mature age from 30 to 44 years.
Average age from 45 to 59 years.
Elderly age from 60 to 74 years.
Senile age from 75 to 89 years.
Long-livers from 90 years and older.

All this time, cardiovascular work is undergoing changes and has some features:

During the day, the heart of an adult pumps more than 6,000 liters of blood. Its dimensions are equal to 1/200 of the body part (for men, the mass of the organ is about 300 g, and for women, about 220 g). The total volume of blood in a person weighing 70 kg is 5-6 liters.
The heart rate in an adult is 66-72 beats. in min.
At the age of 20-25, the valve flaps thicken, become uneven, and in the elderly and senile age, partial muscle atrophy occurs.
From the age of 40, calcium deposits begin, at the same time, atherosclerotic changes in the vessels progress (see), which leads to a loss of elasticity of the blood walls.
Such changes entail an increase in blood pressure, especially this trend is observed from the age of 35.
With aging, the number of red blood cells decreases, and, consequently, hemoglobin. In this regard, drowsiness, fatigue, dizziness may be felt.
Changes in the capillaries make them permeable, which leads to a deterioration in the nutrition of body tissues.
With age, myocardial contractility also changes. In adults and the elderly, cardiomyocytes do not divide, so their number may gradually decrease, and connective tissue is formed at the site of their death.
The number of cells of the conducting system begins to decrease from the age of 20, and in old age their number will be only 10% of the original number. All this creates the prerequisites for the violation of the rhythm of the heart in old age.
Starting from the age of 40, the efficiency of the cardiovascular system decreases. Increases endothelial dysfunction, both in large and small vessels. This affects changes in intravascular hemostasis, increasing the thrombogenic potential of the blood.
Due to the loss of elasticity of large arterial vessels, cardiac activity becomes less and less economical.

Features of the cardiovascular system in the elderly are associated with a decrease in the adaptive capacity of the heart and blood vessels, which is accompanied by a decrease in resistance to adverse factors. It is possible to ensure maximum life expectancy by preventing the occurrence of pathological changes.

According to cardiologists, in the next 20 years, diseases of the cardiovascular system will determine almost half of the mortality of the population.

Attention: for 70 years of life, the heart pumps about 165 million liters of blood.

As we can see, the features of the development of the cardiovascular system are really amazing. It is amazing how clearly nature has planned all the changes to ensure normal human life.

To prolong your life and ensure a happy old age, you need to follow all the recommendations for a healthy lifestyle and maintaining heart health.