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1.
Braz. j. oral sci ; 21: e226262, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1354997

RESUMO

Aim: To evaluate the impact of a dual-cured adhesive system on the in situ degree of conversion (DC), bond strength (BS) and failure mode (FM) of adhesive interfaces in dentin cavities restored with a bulk-fill resin composite. Methods: 4-mm-deep dentin cavities with a 3.1 C-factor were created in 68 bovine incisors (n = 17 per group). The lightcured (Scotchbond™ Universal) or the dual-cured (Adper™ Scotchbond™ Multi-purpose Plus) adhesive system was applied to the cavities, which were then restored with a bulkfill resin composite (Filtek™ Bulk Fill). In situ DC analysis was performed by means of micro Raman spectroscopy at the top and bottom interfaces. Push-out BS was measured in a universal testing machine after 24-h or 6-month water storage. FM was determined with a stereomicroscope. Data of in situ DC and BS were analyzed by two-way analysis of variance (ANOVA) and Tukey test (p<0.05), while the FM was analyzed descriptively. Results: The groups that received the dual-cured adhesive system showed statistically higher in situ DC and BS than those that received the light-cured adhesive system. Cohesive failure mode was the most frequent in all conditions. Conclusion: In situ DC and BS were influenced by the curing strategies of the adhesive systems with better performance of the dual-cured material


Assuntos
Envelhecimento , Adesivos Dentinários , Resinas Compostas , Fenômenos Físicos , Polimerização
2.
Braz. j. oral sci ; 21: e225454, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1366512

RESUMO

Aim: Evaluating the resin-dentin bond strength of Class II conventional and bulk-fill composite restorations, using different cavity sizes before and after aging. Methods: Seventy-five human molars were distributed into groups according to the buccolingual width of the cavities, conservative (n=25) and extended (n=50). They were divided according to the restorative material: conventional (Z100/control group) or bulk-fill resin composites (Filtek Bulk Fill/FBF; Tetric N Ceram Bulk Fill/TNCBF; Filtek Bulk Fill Flow/FBFF; Surefill SDR flow/SDR). The restored teeth were sectioned on sticks (n=50 per restorative materials + width cavities group), half were stored in Water/Ethanol 75% for 30 days and the other half were submitted to the immediate microtensile bond strength (µTBS) test. Data were analyzed applying the Three-Way Analysis of Variance (ANOVA), Bonferroni test, test t, and Weibull analyses (p<0.05). Results: SDR and FBF presented lower µTBSvalues for extended preparation when compared to the conservative preparation, before aging. After aging, only for the FBFF, a decrease in the µTBSvalues was observed. Comparing the µTBSvalues, before and after aging, the SDR demonstrated lower µTBSvalues after aging when the conservative cavity was used. A decrease in the µTBSvalues was observed for the Z100, the FBF and, the FBFF, after aging, when the extended cavity was used. Conclusion: The effect of cavity preparation and aging on the resin-dentin of Class II is material dependent. Most of the bulk-fill resin composites evaluated presented a similar performance to the conventional resin composites for all the conditions of this study


Assuntos
Humanos , Resistência à Tração , Envelhecimento , Resinas Compostas/análise , Preparo da Cavidade Dentária
3.
BMC Public Health ; 22(1): 1499, 2022 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-35932016

RESUMO

BACKGROUND: Understanding how urban environments influence people's health, especially as individuals age, can help identify ways to improve health in the rapidly urbanizing and rapidly aging populations. OBJECTIVES: To investigate the association between age and self-reported health (SRH) in adults living in Latin-American cities and whether gender and city-level socioeconomic characteristics modify this association. METHODS: Cross-sectional analyses of 71,541 adults aged 25-97 years, from 114 cities in 6 countries (Argentina, Brazil, Colombia, Chile, El Salvador, and Guatemala), as part of the Salud Urbana en America Latina (SALURBAL) Project. We used individual-level age, gender, education, and self-reported health (SRH) data from harmonized health surveys. As proxies for socioeconomic environment we used a city-level socioeconomic index (SEI) calculated from census data, and gross domestic product (GDP) per-capita. Multilevel Poisson models with a robust variance were used to estimate relative risks (RR), with individuals nested in cities and binary SRH (poor SHR vs. good SRH) as the outcome. We examined effect modification by gender and city-level socioeconomic indicators. RESULTS: Overall, 31.4% of the sample reported poor SRH. After adjusting for individual-level education, men had a lower risk of poor SRH (RR = 0.76; CI 0.73-0.78) compared to women, and gender modified the association between age and poor SRH (p-value of interaction < 0.001). In gender stratified models, the association between older age and poor SRH was more pronounced in men than in women, and in those aged 25-65 than among those 65+ (RR/10 years = 1.38 vs. 1.10 for men, and RR/10 years = 1.29 vs. 1.02 for women). Living in cities with higher SEI or higher GDP per-capita was associated with a lower risk of poor SRH. GDP per-capita modified the association between age (25-65) and SRH in men and women, with SEI the interaction was less clear. CONCLUSIONS: Across cities in Latin America, aging impact on health is significant among middle-aged adults, and among men. In both genders, cities with lower SEI or lower GDP per-capita were associated with poor SRH. More research is needed to better understand gender inequalities and how city socioeconomic environments, represented by different indicators, modify exposures and vulnerabilities associated with aging.


Assuntos
Envelhecimento , Hispânico ou Latino , Adulto , Cidades , Estudos Transversais , Feminino , Humanos , América Latina , Masculino , Pessoa de Meia-Idade , Autorrelato , Fatores Socioeconômicos
4.
Gut Microbes ; 14(1): 2107288, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35939616

RESUMO

Human longevity has a strong familial and genetic component. Dynamic characteristics of the gut microbiome during aging associated with longevity, neural, and immune function remained unknown. Here, we aim to reveal the synergistic changes in gut microbiome associated with decline in neural and immune system with aging and further obtain insights into the establishment of microbiome homeostasis that can benefit human longevity. Based on 16S rRNA and metagenomics sequencing data for 32 longevity families including three generations, centenarians, elderly, and young groups, we found centenarians showed increased diversity of gut microbiota, severely damaged connection among bacteria, depleted in microbial-associated essential amino acid function, and increased abundance of anti-inflammatory bacteria in comparison to young and elderly groups. Some potential probiotic species, such as Desulfovibrio piger, Gordonibacter pamelaeae, Odoribacter splanchnicus, and Ruminococcaceae bacterium D5 were enriched with aging, which might possibly support health maintenance. The level of Amyloid-ß (Aß) and brain-derived neurotrophic factor (BDNF) related to neural function showed increased and decreased with aging, respectively. The elevated level of inflammatory factors was observed in centenarians compared with young and elderly groups. The enriched Bacteroides fragilis in centenarians might promote longevity through up-regulating anti-inflammatory factor IL-10 expression to mediate the critical balance between health and disease. Impressively, the associated analysis for gut microbiota with the level of Aß, BDNF, and inflammatory factors suggests Bifidobacterium pseudocatenulatum could be a particularly beneficial bacteria in the improvement of impaired neural and immune function. Our results provide a rationale for targeting the gut microbiome in future clinical applications of aging-related diseases and extending life span.Abbreviations: 16S rRNA: 16S ribosomal RNA; MAGs: Metagenome-assembled genomes; ASVs: Amplicon sequence variants; DNA: Deoxyribonucleic acid; FDR: False discovery rate: KEGG: Kyoto Encyclopedia of Genes and Genomes; PCoA: Principal coordinates analysis; PCR: Polymerase chain reaction; PICRUSt: Phylogenetic Investigation of Communities by Reconstruction of Unobserved States; Aß: Amyloid-ß (Aß); BDNF: Brain-derived neurotrophic factor.


Assuntos
Microbioma Gastrointestinal , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Bactérias/genética , Fator Neurotrófico Derivado do Encéfalo/genética , Fezes/microbiologia , Microbioma Gastrointestinal/genética , Humanos , Imunidade , Longevidade , Filogenia , RNA Ribossômico 16S/genética
5.
Proc Natl Acad Sci U S A ; 119(33): e2201371119, 2022 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-35939680

RESUMO

Aging is the price to pay for acquiring and processing energy through cellular activity and life history productivity. Climate warming can exacerbate the inherent pace of aging, as illustrated by a faster erosion of protective telomere DNA sequences. This biomarker integrates individual pace of life and parental effects through the germline, but whether intra- and intergenerational telomere dynamics underlies population trends remains an open question. Here, we investigated the covariation between life history, telomere length (TL), and extinction risk among three age classes in a cold-adapted ectotherm (Zootoca vivipara) facing warming-induced extirpations in its distribution limits. TL followed the same threshold relationships with population extinction risk at birth, maturity, and adulthood, suggesting intergenerational accumulation of accelerated aging rate in declining populations. In dwindling populations, most neonates inherited already short telomeres, suggesting they were born physiologically old and unlikely to reach recruitment. At adulthood, TL further explained females' reproductive performance, switching from an index of individual quality in stable populations to a biomarker of reproductive costs in those close to extirpation. We compiled these results to propose the aging loop hypothesis and conceptualize how climate-driven telomere shortening in ectotherms may accumulate across generations and generate tipping points before local extirpation.


Assuntos
Lagartos , Encurtamento do Telômero , Adulto , Envelhecimento/genética , Animais , Feminino , Humanos , Recém-Nascido , Lagartos/fisiologia , Reprodução/genética , Telômero/genética
6.
Prog Brain Res ; 273(1): 257-273, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35940719

RESUMO

Optical and neural changes in the aging human visual system are reviewed in terms of factors that can influence the study of light-mediated effects on circadian physiology. All aspects of early stage visual mechanisms change continuously from the first days of life, and these changes must be understood when investigating both conscious and unconscious visual responses to light throughout the life span.


Assuntos
Envelhecimento , Envelhecimento/fisiologia , Humanos
7.
Prog Brain Res ; 273(1): 331-355, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35940722

RESUMO

Globally, society is aging and changes to the timing and quality of sleep are often observed in older adults (aged ≥65years). Good sleep quality, and sufficient sleep duration, is necessary to maintain good physical and psychological health, and strategies which optimize good sleep will be important in an aging society. Light has a very powerful effect upon sleep and circadian rhythms, and has specific advantages including the relative low cost, ease of administration and lack of interaction with other medications. For this reason, bright light treatment is a promising method for optimizing sleep and circadian rhythmicity in older adults. In this chapter, we examine whether bright light treatment could be used to optimize sleep, circadian rhythms, and health in older adults. We also outline a range of methodological considerations which need to be addressed to increase the feasibility, acceptability and effectiveness of light treatment in older adults.


Assuntos
Ritmo Circadiano , Sono , Idoso , Envelhecimento , Cognição , Humanos
8.
Front Endocrinol (Lausanne) ; 13: 885879, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35937818

RESUMO

Progressive bone loss during aging makes osteoporosis one of the most common and life impacting conditions in geriatric populations. The bone homeostasis is maintained through persistent remodeling mediated by bone-forming osteoblast and bone-resorbing osteoclast. Inflammaging, a condition characterized by increased pro-inflammatory markers in the blood and other tissues during aging, has been reported to be associated with skeletal stem/progenitor cell dysfunction, which will result in impaired bone formation. However, the role of age-related inflammation and metabolites in regulation of osteoclast remains largely unknown. In the present study, we observed dichotomous phenotypes of anti-inflammatory metabolite itaconate in responding to inflammaging. Itaconate is upregulated in macrophages during aging but has less reactivity in responding to RANKL stimulation in aged macrophages. We confirmed the inhibitory effect of itaconate in regulating osteoclast differentiation and activation, and further verified the rescue role of itaconate in lipopolysaccharides induced inflammatory bone loss animal model. Our findings revealed that itaconate is a crucial regulatory metabolite during inflammaging that inhibits osteoclast to maintain bone homeostasis.


Assuntos
Osteoclastos , Succinatos , Envelhecimento , Animais , Osteoblastos/fisiologia , Osteoclastos/metabolismo , Succinatos/metabolismo , Succinatos/farmacologia , Succinatos/uso terapêutico
9.
Women Health ; 62(7): 577-579, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35938358
10.
Perspect Biol Med ; 65(2): 345-355, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938442

RESUMO

Aging is a universal phenomenon, only recently of broad interest to the scientific community, despite its importance to public health. The books under review here, Sinclair and LaPlante's Lifespan (2019) and Armstrong's Borrowed Time (2019), examine the various causes of the aging process. The first concentrates primarily on one family of the many theories in existence; the second offers a broader context. Neither adequately examines the sociopolitical implications of population aging that have already begun to affect the high-income countries of the world and will very soon roil the poorer regions of the planet as well. Both books suffer from a rosy view of how we might improve or slow the aging process, and neither offers serious solutions for the challenges that await us-demographic, clinical, and ethical. Unfortunately, although much serious scientific work is now evident, the field has become polluted by those who wish to take advantage of this newly discovered market. Although the authors of the books under review are not a part of this pernicious and cynical trend, neither do they adequately warn the readers if its imminence.


Assuntos
Envelhecimento , Longevidade , Humanos
11.
Front Endocrinol (Lausanne) ; 13: 916139, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35909509

RESUMO

Mice with genetic growth hormone (GH) deficiency or GH resistance live much longer than their normal siblings maintained under identical conditions with unlimited access to food. Extended longevity of these mutants is associated with extension of their healthspan (period of life free of disability and disease) and with delayed and/or slower aging. Importantly, GH and GH-related traits have been linked to the regulation of aging and longevity also in mice that have not been genetically altered and in other mammalian species including humans. Avai+lable evidence indicates that the impact of suppressed GH signaling on aging is mediated by multiple interacting mechanisms and involves trade-offs among growth, reproduction, and longevity. Life history traits of long-lived GH-related mutants include slow postnatal growth, delayed sexual maturation, and reduced fecundity (smaller litter size and increased intervals between the litters). These traits are consistent with a slower pace-of-life, a well-documented characteristic of species of wild animals that are long-lived in their natural environment. Apparently, slower pace-of-life (or at least some of its features) is associated with extended longevity both within and between species. This association is unexpected and may appear counterintuitive, because the relationships between adult body size (a GH-dependent trait) and longevity within and between species are opposite rather than similar. Studies of energy metabolism and nutrient-dependent signaling pathways at different stages of the life course will be needed to elucidate mechanisms of these relationships.


Assuntos
Nanismo Hipofisário , Hormônio do Crescimento , Envelhecimento/fisiologia , Animais , Hormônio do Crescimento/metabolismo , Humanos , Longevidade/fisiologia , Mamíferos/metabolismo , Camundongos , Reprodução/fisiologia
12.
Front Endocrinol (Lausanne) ; 13: 918212, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35909541

RESUMO

Background: The decline in the quantity and quality of oocytes due to ovarian ageing in women is now a significant threat to reproductive health today as the concept of delayed fertility becomes widespread. However, the molecular mechanisms of natural ovarian ageing have not been fully elucidated. Method: Here, we used transcriptomic data from 180 normal ovarian tissues from GTEx V8 to analyze the expression profile of ovarian tissues from women with age segments of 20-29 (22 individuals), 30-39 (14 individuals), 40-49 (37 individuals), 50-59 (61 individuals), 60-69 (42 individuals), and 70-79 (4 individuals), respectively. XCELL was used to assess the infiltration score of 64 cell types of the ovary. WGCNA was used to characterize the co-expression network during the natural aging of the ovary. ClusterprofileR was used for functional enrichment analysis of co-expression modules. MsViper was used for master regulator analysis. Results: The infiltration score of endothelial cells and activated antigen-presenting cells during natural ovarian ageing increased significantly at ages 30-39, 40-49, and then decreased, whereas CD4+ Tcm increased with age. WGCNA identified six co-expression modules from ovarian tissue transcriptomic data species. The red module was significantly and positively correlated with senescence and CD4+ Tcm, and the turquoise module was significantly and positively correlated with Endothelial Cells. We further explored ovarian tissue for women aged 20-29 and 30-39 years. The GSEA results showed that the Chemokine signaling pathway was significantly activated in the 30-39-year-old group, while Oocyte meiosis was significantly inhibited. Finally, the results of msviper found that transcription factors such as KDM1A, PRDM5, ZNF726, PPARG, FOXJ2, and GLI2 were mainly activated in the 20-29 years group, while VAV1, RUNX3, ZC3H12D, MYCL, and IRF5 were mainly activated in the 30-39 years group and that these transcription factor activities were diagnostic of natural ovarian ageing (AUC: 0.65-0.71). Conclusion: Natural ageing of the ovary is significantly correlated with immune cell infiltration and activation of inflammation-related signaling pathways, with inflammation levels reaching a maximum during early ovarian ageing (30-39, 40-49) and then gradually decreasing after that. These studies provide a research basis for exploring the mechanisms of natural ovarian ageing.


Assuntos
Células Endoteliais , Ovário , Envelhecimento/genética , Feminino , Fatores de Transcrição Forkhead , Perfilação da Expressão Gênica , Histona Desmetilases , Humanos , Inflamação , Ovário/fisiologia
13.
Oxid Med Cell Longev ; 2022: 7378403, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35910839

RESUMO

Objective: Degenerative kyphoscoliosis (DKS) is a complex spinal deformity associated with degeneration of bones, muscles, discs, and facet joints. The aim of this study was to establish an animal model of degenerative scoliosis that recapitulates key pathological features of DKS and to validate the degenerative changes in senescence-accelerated mouse prone 8 (SAMP8) mice. Methods: Thirty male mice were divided into 2 groups: 10 bipedal C57BL/6J mice were used as the control group, and 20 bipedal SAMP8 mice were used as the experimental group. Mice were bipedalized under general anesthesia. The incidence of scoliosis and bone quality was determined using radiographs and in vivo micro-CT images 4, 8, and 12 weeks after surgery, respectively. Histomorphological studies of muscle samples were performed after sacrifice at 12 weeks after surgery. Results: On the 12th week, the incidence rates of kyphosis in C57BL/6J and SAMP8 groups were 50% and 100%, respectively. Overall, the incidence and angle of kyphosis were significantly higher in the bipedal SAMP8 group compared to the C57BL/6J group (44.7°± 6.2° vs. 84.3°± 10.3°, P<0.001). Based on 3D reconstruction of the entire spine, degeneration of the intervertebral disc was observed in bipedal SAMP8 mice, including the reduction of disc height and the formation of vertebral osteophytes. The bone volume ratio (BV/TV) was significantly suppressed in the bipedal SAMP8 group compared with the bipedal C57BL/6J group. In addition, HE staining and Mason staining of the paraspinal muscle tissue showed chronic inflammation and fibrosis in the muscles of the bipedal SAMP8 group. Conclusions: The SAMP8 mouse model can be taken as a clinically relevant model of DKS, and accelerated aging of the musculoskeletal system promotes the development of kyphosis.


Assuntos
Cifose , Escoliose , Envelhecimento , Animais , Modelos Animais de Doenças , Cifose/cirurgia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Escoliose/cirurgia
14.
J Clin Invest ; 132(15)2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35912854

RESUMO

Cellular senescence is a hallmark of aging defined by stable exit from the cell cycle in response to cellular damage and stress. Senescent cells (SnCs) can develop a characteristic pathogenic senescence-associated secretory phenotype (SASP) that drives secondary senescence and disrupts tissue homeostasis, resulting in loss of tissue repair and regeneration. The use of transgenic mouse models in which SnCs can be genetically ablated has established a key role for SnCs in driving aging and age-related disease. Importantly, senotherapeutics have been developed to pharmacologically eliminate SnCs, termed senolytics, or suppress the SASP and other markers of senescence, termed senomorphics. Based on extensive preclinical studies as well as small clinical trials demonstrating the benefits of senotherapeutics, multiple clinical trials are under way. This Review discusses the role of SnCs in aging and age-related diseases, strategies to target SnCs, approaches to discover and develop senotherapeutics, and preclinical and clinical advances of senolytics.


Assuntos
Envelhecimento , Senescência Celular , Envelhecimento/genética , Envelhecimento/patologia , Animais , Ciclo Celular , Senescência Celular/fisiologia , Camundongos , Camundongos Transgênicos , Cicatrização
15.
Zhonghua Nei Ke Za Zhi ; 61(8): 965-968, 2022 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-35922226
17.
Dermatol Surg ; 48(8): 878, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35917266
18.
Rev Gaucha Enferm ; 43: e20200493, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35920519

RESUMO

OBJECTIVE: To reveal the conditions that allow the Open University for the Elderly to be a possibility for active aging. METHOD: Qualitative study anchored in the theoretical framework of Symbolic Interactionism and in the methodology of Grounded Theory. From April to October 2020, 14 elderly people, two coordinators, and six teachers linked to university activities for the elderly participated in individual interviews. Data analysis was carried out by three interdependent coding steps - open, axial and integration - with the support of the Atlas.ti software. RESULTS: The conditions that allow the program to be configured as an opportunity for active aging are related to the meanings attributed to aging well; the social determination of participation; motivations in the search for the program; the functions performed by the program; and public and institutional policies of the university to which it is linked. FINAL CONSIDERATIONS: University activities for the elderly are a possibility for active aging, but socially constructed barriers make access to them difficult.


Assuntos
Envelhecimento , Motivação , Idoso , Teoria Fundamentada , Humanos , Pesquisa Qualitativa , Universidades
19.
Age Ageing ; 51(8)2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35930721

RESUMO

BACKGROUND: a Frailty Index (FI) calculated by the accumulation of deficits is often used to quantify the extent of frailty in individuals in specific settings. This study aimed to derive a FI that can be applied across three standardised international Residential Assessment Instrument assessments (interRAI), used at different stages of ageing and the corresponding increase in support needs. METHODS: deficit items common to the interRAI Contact Assessment (CA), Home Care (HC) or Long-Term Care Facilities assessment (LTCF) were identified and recoded to form a cumulative deficit FI. The index was validated using a large dataset of needs assessments of older people in New Zealand against mortality prediction using Kaplan Meier curves and logistic regression models. The index was further validated by comparing its performance with a previously validated index in the HC cohort. RESULTS: the index comprised 15 questions across seven domains. The assessment cohort and their mean frailty (SD) were: 89,506 CA with 0.26 (0.15), 151,270 HC with 0.36 (0.15) and 83,473 LTCF with 0.41 (0.17). The index predicted 1-year mortality for each of the CA, HC and LTCF, cohorts with area under the receiver operating characteristic curves (AUCs) of 0.741 (95% confidence interval, CI: 0.718-0.762), 0.687 (95%CI: 0.684-0.690) and 0.674 (95%CI: 0.670-0.678), respectively. CONCLUSIONS: the results for this multi-instrument FI are congruent with the differences in frailty expected for people in the target settings for these instruments and appropriately associated with mortality at each stage of the journey of progressive ageing.


Assuntos
Fragilidade , Serviços de Assistência Domiciliar , Idoso , Envelhecimento , Idoso Fragilizado , Fragilidade/diagnóstico , Avaliação Geriátrica/métodos , Humanos
20.
Age Ageing ; 51(8)2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35930723

RESUMO

Blood pressure regulation is an automatic, moment-by-moment buffering of the blood pressure in response to physiological changes such as orthostasis, exercise and haemorrhage. This finely orchestrated reflex is called the baroreflex. It is a regulated arc of afferent, central and efferent arms. Multiple physiological changes occur with ageing that can disrupt this reflex, making blood pressure regulation less effective. In addition, multiple changes can occur with ageing-related diseases such as neurodegeneration, atherosclerosis, deconditioning and polypharmacy. These changes commonly result in orthostatic hypotension, hypertension or both, and are consistently associated with multiple adverse outcomes. In this article, we discuss the healthy baroreflex, and physiological and pathophysiological reasons for impaired baroreflex function in older people. We discuss why the common clinical manifestations of orthostatic hypotension and concomitant supine hypertension occur, and strategies for balancing these conflicting priorities. Finally, we discuss strategies for treating them, outlining our practice alongside consensus and expert guidance.


Assuntos
Hipertensão , Hipotensão Ortostática , Idoso , Envelhecimento , Sistema Nervoso Autônomo , Barorreflexo/fisiologia , Pressão Sanguínea , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipotensão Ortostática/complicações , Hipotensão Ortostática/diagnóstico , Hipotensão Ortostática/terapia
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