Even without the presence of disease, a person's body will undergo changes in its structure and function. Aging is an independent risk factor for cardiovascular disease. The effects of aging are widely diverse and can be identified at the molecular, cellular, tissue, organ, and system levels as contributing to the altered function of the cardiovascular system. Structural changes with aging involve the myocardium, the cardiac conduction system, and the endocardium. There is a progressive degeneration of the cardiac structures with aging, including a loss of elasticity, fibrotic changes in the valves of the heart, and infiltration with amyloid.The age-associated structural characteristics that have the greatest impact involve the contractility of the heart's left ventricular wall. The pumping capacity of the heart is reduced with age due to a variety of changes affecting the structure and function of the heart muscle.
For decades, it was thought that the heart undergoes atrophy with advancing age, but evidence suggests that an age-related increase in the left ventricular posterior wall thickness of approximately 25% has been found between the second and the seventh decade. An increase in heart mass with aging, for the most part, is due to an increase in the average myocyte size, whereas the number of myocardial cells declines. Again, the decline in left ventricular compliance provides an increase work load on the atria, resulting in hypertrophy of the atria.