title: Aging in blood vessels. Medicinal agents FOR systemic arterial hypertension in the elderly.
abstract: Aging impairs blood vessel function and leads to cardiovascular disease. The mechanisms underlying the age-related endothelial, smooth muscle and extracellular matrix vascular dysfunction are discussed. Vascular dysfunction is caused by: (1) Oxidative stress enhancement. (2) Reduction of nitric oxide (NO) bioavailability, by diminished NO synthesis and/or augmented NO scavenging. (3) Production of vasoconstrictor/vasodilator factor imbalances. (4) Low-grade pro-inflammatory environment. (5) Impaired angiogenesis. (6) Endothelial cell senescence. The aging process in vascular smooth muscle is characterized by: (1) Altered replicating potential. (2) Change in cellular phenotype. (3) Changes in responsiveness to contracting and relaxing mediators. (4) Changes in intracellular signaling functions. Systemic arterial hypertension is an age-dependent disorder, and almost half of the elderly human population is hypertensive. The influence of hypertension on the aging cardiovascular system has been studied in models of hypertensive rats. Treatment for hypertension is recommended in the elderly. Lifestyle modifications, natural compounds and hormone therapies are useful for initial stages and as supporting treatment with medication but evidence from clinical trials in this population is needed. Since all antihypertensive agents can lower blood pressure in the elderly, therapy should be based on its potential side effects and drug interactions.
authors.affiliation: Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", México, DF, Mexico.
authors.forename: María Esther
authors.initials: ME
authors.lastname: Rubio-Ruiz
authors.affiliation: Department of Pathology, Instituto Nacional de Cardiología "Ignacio Chávez", México, DF, Mexico.
authors.forename: Israel
authors.initials: I
authors.lastname: Pérez-Torres
authors.affiliation: Department of Immunology, Instituto Nacional de Cardiología "Ignacio Chávez", México, DF, Mexico.
authors.forename: María Elena
authors.initials: ME
authors.lastname: Soto
authors.affiliation: Department of Pharmacology, Instituto Nacional de Cardiología "Ignacio Chávez", México, DF, Mexico.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Pastelín
authors.affiliation: Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", México, DF, Mexico. Electronic address: gualanv@yahoo.com.
authors.forename: Verónica
authors.initials: V
authors.lastname: Guarner-Lans
mesh_terms: D000367:Age Factors; D000375:Aging / Q000378:metabolism; D000818:Animals; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects*; D016922:Cellular Senescence; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D005109:Extracellular Matrix / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D007333:Insulin Resistance; D009131:Muscle, Smooth, Vascular / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D015398:Signal Transduction; D016896:Treatment Outcome; D066253:Vascular Remodeling; D059289:Vascular Stiffness
chemical_list: D000959:Antihypertensive Agents
keywords: Aging; Endothelial cells; Hypertension; Medicinal agents