Shadow Health Reflection Assignment Paper
Shadow Health Reflection Assignment Paper
Module 3 – The Cardiovascular System
After completing Module 3 in Shadow Health, discuss one of the following aspects of pathophysiology as it relates to aging and the cardiovascular system:
Changes to the Renin Angiotensin Aldosterone System effects on the cardiovascular system and aging
Pathophysiologic changes of aging and blood pressure
Pathophysiologic changes pertaining to cardiac output and aging
Include a summary of what you found helpful in this module or what was not helpful.
Directions:
The assignment should be at least 2 pages
The paper should be in APA format and include: Shadow Health Reflection Assignment Paper
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Title page
Appropriate citations
Reference page
Introduction/Conclusion
Include at least one scholarly reference (this is a peer reviewed research article) to support the assignment
Provide references in APA format following your summary
Submit to the assignment link
Introduction
According to Lucia et al. (2018), cardiac output is measured in liters per minute and it refers to the product of stroke volume and heart rate. The most common definition of heart rate is the number of times a heartbeat occurs in one minute. The blood volume released throughout the contraction of the ventricles or during every heart stroke is referred to as stroke volume. Age-related changes in the heart and lungs are common, and aging is a cardiovascular disease risk factor. Several other changes associated with aging, in contrast, are caused or exacerbated by risk variables. The repercussions of aging are numerous and may be outlined at any level of the human body (molecular, cellular, tissue, organ, and system) as attributing to changed cardiovascular system function. Below is a discussion of the pathophysiologic changes pertaining to cardiac output and aging. Shadow Health Reflection Assignment Paper
Pathophysiologic changes
Endothelial dysfunction
Through adjusting anti- and pro-oxidation, vasoconstriction and vasodilation, promotion and growth inhibition, anti- and pro-inflammation, and anti- and pro-thrombosis, the endothelium actively maintains vascular equilibrium (Lucia et al., 2018). Endothelial cells release a variety of vasoactive molecules, including vasodilators like prostacyclin, nitric oxide, and endothelium-derived hyperpolarizing factor, along with vasoconstrictors like thromboxane A2, angiotensin II, endothelin-1, and angiotensin II. Nitric oxide-mediated vasodilation is the most commonly utilized method for examining age-related changes in endothelial function. Reduction in nitric oxide-mediated vasodilator responses with age have been evidenced at all levels of the vasculature, right from the coronary microcirculation to pulse pressure and larger cardiac arteries Shadow Health Reflection Assignment Paper.
Endothelial-dependent limb hypoxia declines gradually with changing age in men, but not until approximately ten years later in females. Rising oxidative stress with an elevated generation of ROS “reactive oxygen species” are among the underlying mechanisms. This involves reducing nitric oxide output by preventing the expression of eNOS “endothelial nitric oxide synthase” and triggering eNOS uncoupling. Another mechanism is elevated arginase activity that also effectively confines the presence of eNOS “endothelial nitric oxide synthase substrate” and reduces nitric oxide production. Vasoconstrictors like endothelin-1, endoperoxide, and thromboxane, are also produced in greater quantities. The final mechanism is reduced endothelial regeneration potential because of the declining provision of endothelial progenitor cells and endothelial cell aging (Song et al., 2021)Shadow Health Reflection Assignment Paper.
Increased arterial stiffness
Song et al. (2021) indicate that the arterial wall undergoes age-related adjustments. A viscoelastic tube is an arterial tree. The pivotal arteries seem to be more elastic and less rigid in young adults than the arterial vessels. In comparison to vessels from healthy young adults, arteries from elderly adults have higher levels of ROS “reactive oxygen species”, inflammation changes, endothelial dysfunction, and decreased nitric oxide availability. Such changes result in a reversed rigidity gradient along the arterial tree, with greater central artery rigidity than arterial vessels. Generally, arteries become thicker, wider, longer, and stiffer as people age. Vascular aging is marked by reduced dispensability or elevated rigidity of the large central arteries (Lucia et al., 2018)Shadow Health Reflection Assignment Paper.
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Age-Related Heart Structural Changes
Age-related structural changes involve the endocardium, cardiac conduction system, and myocardium. Cardiac structures degenerate progressively with changes in the fibers of the heart valves, the infiltration in the amyloid, and the loss of elasticity (Turetz et al., 2018). The greatest impact experienced involves the contractive characteristics of the ventricular walls of the heart, whereby its pumping capacity reduces with age. The reduction in pumping capacity is because of changes that affect the function and structure of heart muscles. Between ages 20 to 70 years, there is an approximate 25% thickening of the ventricular posterior walls of the left ventricle. The increased heart mass is caused by an increase in myocyte size, whereby myocardial cells increases in number at the same time (Ren et al., 2018)Shadow Health Reflection Assignment Paper. As a result, there is an increased workload on the atria due to its hypertrophy. There is reduced maximum aerobic and cardiac output with age and a moderate rise in blood pressure.
Cardiac conduction system
Decreased number of pacemaker cells affects cardiac conduction in the sinoatrial node among elderly people. These pacemaker cells start reducing at the age of 60 years in the sinoatrial node, and only 10% of the pacemaker cells found in younger adults is found in those at around 75 years of age (Ren et al., 2018). The collagenous and elastic tissues increase in most parts of the conduction system as age advances. At the same time, there is an accumulation of fat around the sinoatrial node, which separates it from atrial musculature.
The valves
All four cardiac valve experience increased valvular circumference with age. These are the tricuspid and bicuspid valves, the semilunar valve at the aorta, and the semilunar valve (Turetz et al., 2018). The aortic valve experiences the greatest change among the four valves. In the cusps of the aortic valve, there is a frequent presence of calcific deposits which might cause valvular stenosis (Ren et al., 2018)Shadow Health Reflection Assignment Paper. Clinical heart murmurs might also be detected frequently.
Blood Vessel changes
There is increased thickening, stiffening, and inflexibility of the aorta due to ten changes in the blood vessel wall of the connective tissue. This raises the blood pressure and overworks the heart leading to myocardium hypertrophy. The arteries stiffen and thicken in general making ten baroreceptors less sensitive in monitoring blood pressure. There is also decreased nutrient and oxygen supply as a result of thickened capillary wall’s baseline membrane (Turetz et al., 2018)Shadow Health Reflection Assignment Paper.
Summary
In summary, the examination of age related functions in endothelia function using nitric oxide-mediated vasodilation is important in cardiac output as its vasodilator responses are evidenced at all levels of vasculature. The increased arterial stiffness age wise helps the young adults to understand the causes and practice healthy lifestyle that helps them to avoid some of the cardiovascular complications related to aging. To the heart structural changes that are age related, there is a need for exercising at younger ages to strengthen the fibers of the heart valves and reduce loss of elasticity later in life. Healthy diet also helps in preventing cardiovascular complications at old age Shadow Health Reflection Assignment Paper.
Conclusion
In conclusion, several cardiovascular changes occur in the human body as they age. These changes affect the body in various ways, putting their lives at a higher risk of suffering age-related diseases such as hypertension and stroke. The amount of blood that the heart pumps per minute or the cardiac output decreases with age as a result of the thickening of the ventricular walls as well as the blood vessel walls. Older people are at high risk of suffering cardiac attacks compared to young ones.
References
Lucia, C. D., Eguchi, A., & Koch, W. J. (2018). New insights in cardiac β-adrenergic signaling during heart failure and aging. Frontiers in pharmacology, 9, 904.
Ren, J., Sowers, J. R., & Zhang, Y. (2018). Metabolic stress, autophagy, and cardiovascular aging: from pathophysiology to therapeutics. Trends in Endocrinology & Metabolism, 29(10), 699-711.
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Song, B., Dang, H., & Dong, R. (2021). Analysis of risk factors of low cardiac output syndrome after congenital heart disease operation: what can we do. Journal of Cardiothoracic Surgery, 16(1), 1-6.
Turetz, M., Sideris, A. T., Friedman, O. A., Triphathi, N., & Horowitz, J. M. (2018, June). Epidemiology, pathophysiology, and natural history of pulmonary embolism. In Seminars in interventional radiology (Vol. 35, No. 02, pp. 92-98). Thieme Medical Publishers Shadow Health Reflection Assignment Paper