[Biology of cardiac and vascular senescence].

None of the many theories of senescence can account for the aging process in its entirety. These theories include the evolutionary theory of aging and its EvoDevo corollary, the replicative senescence and free radicals theory, theories based on large-scale analyses (proteomics, etc.), and systemic theories. Cardiovascular senescence is first and foremost due to vascular senescence. Aging is associated with enhanced aortic characteristic impedance, which is mainly due to glycation of vessel wall proteins. This increased impedance overloads the left ventricle and causes compensatory left ventricular hypertrophy, usually associated with fibrosis. Extreme aging (> 80 years in humans, > 30 months in rats) is associated with age-related heart failure. Senescence favors heart failure, atrial fibrillation and cardiac hypertrophy. It is also associated with increased systolic pressure and decreased diastolic pressure. The most characteristic features are enhanced pulse pressure and arterial compliance.