[The so-called aging heart in 50- to 100-year-old subjects].
The cardiovascular system of aging people exhibits a number of morphological, functional and clinical special features. Alterations in shape, size and weight of the heart, alterations of coronary arteries, valves and aorta are accompanied by typical changes in several hemodynamics variables. The result is a diminution of the adaptation capacity to physical exertion and increased incidence of failure. However, heart failure cannot be regarded as a physiological process; it is caused by a coincidence of an increasing polypathy of the aging heart (coronary artery disease, arteriosclerosis, hypertrophy, valve-changes,disseminated degenerative changes) and the polypathy or multimorbidity of the whole aging organism. In advanced age the various forms of ischaemic heart disease (angina pectoris, infarction, failure, arrhythmias) show increasingly atypical courses, complications and a higher degree of mortality. Modern therapeutic measures like demand pacemakers or bypass operations are principally applicable. Our study of now 326 patients of very high age shows that the good state of their cardiovascular system (probably genetically determined) is mainly responsible for reaching high age.