ABSTRACT
While cardiovascular disease continues to be the major cause of death in the United States and other industrialized, socioeconomically advanced countries, there has been, during the last 50 years, a marked decrease in total death rates in heart disease (by 56%) and stroke (by 70%). Indeed, it is estimated that 73% of the decline in total death rates over this time period was due to this reduction in cardiovascular disease mortality (Chapter 2). Despite this current, extraordinarily rapid decline in mortality, cardiovascular disease associated with advancing age remains the most important
single worldwide cause of death, in old age and in both sexes. This is, in part, because people now live longer and are more susceptible to the occurrence of degenerative diseases. It is also due to some unknown aspects of modern life that are increasing the incidence of atherosclerosis. As outlined in Chapter 2, several concomitant factors may have contributed to the decline in cardiovascular morbidity and mortality such as better control of hypertension, changes in lifestyle (diet, physical exercise), scientific breakthroughs in understanding the disease, improvement in medical care, and decline in cigarette smoking. This chapter will review some of the age-associated changes in structure and func-
tion of the arteries; it will focus on atherosclerosis, the major and universal manifestation of cardiovascular pathology,
and it will emphasize coronary heart disease as an example of its clinical consequences.
