Cardiovascular Risks Associated with Gender and Aging

Abstract

The aging and elderly population are particularly susceptible to cardiovascular disease. Age is an independent risk factor for cardiovascular disease (CVD) in adults, but these risks are compounded by additional factors, including frailty, obesity, and diabetes. These factors are known to complicate and enhance cardiac risk factors that are associated with the onset of advanced age. Sex is another potential risk factor in aging adults, given that older females are reported to be at a greater risk for CVD than age-matched men. However, in both men and women, the risks associated with CVD increase with age, and these correspond to an overall decline in sex hormones, primarily of estrogen and testosterone. Despite this, hormone replacement therapies are largely shown to not improve outcomes in older patients and may also increase the risks of cardiac events in older adults. This review discusses current findings regarding the impacts of age and gender on heart disease.

Keywords: aging; cardiovascular disease; estrogen; gender; testosterone.

Figure 1

Schematic diagram of age-related risk factors for cardiovascular disease (CVD). Age is associated with increased oxidative stress, which leads to an increased susceptibility for functional and electrical abnormalities which lead to CVD. These abnormalities include atrial fibrillation (AF) and heart failure (HF), which are a result of increased reactive oxygen species (ROS) due to oxidative stress and increase production of inflammatory signal molecules. Age is also associated with an increased risk for frailty, obesity, and diabetes. These conditions are also independent risk factors for CVD. Multiple risk factors result in a high incidence of CVD in aging adults. In this figure indicates upregulation. Tumor necrosis factor-α (TNFα), C-reactive protein (CRP), and interleukin-6 (IL-6).

Figure 2

Schematic diagram of the influence of sex hormones on cardiovascular disease (CVD). Male and females both demonstrate a decline in sex hormones, while hormonal decline is more drastic in females with the onset of menopause. The decline of sex hormones is associated with increased cardiac risk in both males and females, with the decline of testosterone and estrogen, respectively. In this figure indicates upregulation and indicates downregulation. Coronary artery disease (CAD) and myocardial infarction (MI).