Cardiovascular changes associated with aging: The anesthetic implications

Successful anesthesia care of the elderly patient is highly dependent on the anesthesia care provider's knowledge of the physiological alterations on the cardiovascular system associated with aging. It is projected that by the year 2000, the elderly segment of the population will increase to 13% and by the year 2030, 52 million Americans, or 17% of the population will be older than age 65. More people than ever before are reaching old age, with the latest statistics indicating that life expectancy for a man of 45 years has increased from 70.4 to 77.3 years and from 77.0 to 82.8 years for a woman. One of the primary factors associated with the increase in longevity is the decrease in mortality from cardiovascular diseases. Since the 1960s, there has been a decline in cardiovascular mortality of about 3% per year. Recent technological advances and healthier lifestyles are among the reasons contributing to this trend. With these positive changes impacting the elderly population, anesthesia care providers must become better prepared to select and administer the appropriate agents that will ultimately influence perioperative outcome.