Arterial and cardiac aging: Major shareholders in cardiovascular disease enterprises Part I: Aging arteries: A "set up" for vascular disease
Arterial and cardiac aging: Major shareholders in cardiovascular disease enterprises Part I: Aging arteries: A "set up" for vascular disease
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DOI：
10.1161/01.cir.0000048892.83521.58
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发表时间：
2003-01-07
期刊：
影响因子：
37.8
通讯作者：
Levy, D
中科院分区：
文献类型：
--
作者：
Lakatta, EG;Levy, D
流行病学家发现的疾病。如果变量被认为是有益的或有害的心血管结构或功能，那些极端的措施被认为是老化“成功”或“不成功”，分别。在这种情况下，"不成功的"衰老并不等同于患有临床疾病，因为患有明确的显性或隐性临床疾病的个体已被排除在先验考虑之外。相反，不成功的老龄化，即属于最贫穷的类别，就被视为有害的措施，可能被视为未来临床心血管疾病的危险因素。在这方面，不成功的老化是血管老化过程和血管疾病病理生理学的特定方面的相互作用的表现。因此，老年病学家和流行病学家已经成为一个共同努力的一部分，在寻求定义为什么老龄化赋予巨大的风险心血管疾病，这篇评论的中心论点是，典型的老年人的临床心血管疾病和年龄相关的心血管结构和功能的变化，迄今未被定义为疾病，变得相互交织和相互依存。心血管结构和功能的特定年龄相关变化在这种年龄与疾病相互作用中的作用以前一直没有被制定医疗政策的人认识到，而且在很大程度上仍然没有被认识到。因此，心血管衰老的具体方面仍然在临床心脏病学的范围之外，直到最近，在大多数心血管疾病的流行病学研究中还没有考虑到。我们的主要目标是通过定义我们目前对明显健康人群中发生的心脏和血管结构和功能的年龄相关变化的理解，以及这些变化与随后心血管疾病发生风险的关系，来促进新的研究前沿。这一目标在本系列的这两篇文章中得到了实现，这两篇文章将出现在随后的《循环》杂志中，以激发人们对新的重要研究工作的思考，这些研究工作旨在设计阐明这些机制的基础实验和评估旨在减少或预防衰老的那些方面的策略的临床试验，例如与年龄相关的大血管腔增加，壁增厚和僵硬，发生在表面上健康的人身上，但却有明显的临床心血管疾病的风险。
disease identified by the epidemiologists. If the variable is perceived as beneficial or deleterious with respect to cardiovascular structure or function, those with extreme measures are considered to be aging “successfully” or “unsuccessfully,” respectively.“Unsuccessful” aging in this context is not synonymous with having clinical disease, as individuals with defined overt or occult clinical disease have been excluded from consideration a priori. Instead, unsuccessful aging, ie, falling within the poorest category with respect to the measure viewed as deleterious, may be viewed as a risk factor for future clinical cardiovascular disease. In this regard, unsuccessful aging is a manifestation of the interaction of the vascular aging process and specific aspects of vascular disease pathophysiology. Thus, gerontologists and epidemiologists have become part of a joint effort in the quest to define why aging confers enormous risk for cardiovascular disease.The central thesis of this review is that quintessential clinical cardiovascular diseases of older persons and ageassociated changes in cardiovascular structure and function, heretofore not defined as disease, become intertwined and interdependent. The role of specific age-associated changes in cardiovascular structure and function in this age–disease interaction has formerly been, and largely continues to be, unrecognized by those who shape medical policy. Thus, specific aspects of cardiovascular aging have remained outside the bailiwick of clinical cardiology, and, until recently, have not been considered in most epidemiological studies of cardiovascular disease. Our main goal is to promote a new research frontier by defining our current understanding of the age-associated changes in cardiac and vascular structure and function that occur in apparently healthy persons and how these are relate to the risk of subsequent cardiovascular disease occurrence. This goal is pursued in this and the additional two articles of this series that will occur in subsequent issues of Circulation1, 2 to provoke thought regarding the new and important research efforts to design basic experiments that elucidate these mechanisms and clinical trials that evaluate strategies aimed at reducing or preventing those aspects of aging, such as age-associated increases in large vessel lumen, wall thickening, and stiffness, that occur in apparently healthy persons but confer risk for overt clinical cardiovascular disease.