Hypertension and aging adversely affect cardiovascular system and the heart
is invariably involved. Manifestations of hypertensive heart disease and o
f the aging heart appear similar; ventricular hypertrophy, myocardial fibro
sis, and impairments in ventricular function and coronary hemodynamics char
acterize both conditions. However, a great deal of evidence suggests that d
ifferent underlying pathophysiological mechanisms may be involved. This rep
ort discusses most recent clinical and experimental findings and focuses on
the alterations in nonmyocytic elements that are a part of heart involveme
nt. Particular attention was given to factors that are responsible for exag
gerated myocardial deposition of collagen that, by itself, may be responsib
le for ventricular dysfunction and impaired coronary hemodynamics in hypert
ensive and aging hearts. Newly developed therapeutical strategies, based on
the most recent experimental and clinical studies, are also discussed. (C)
2001 Lippincott Williams & Wilkins, Inc.