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Loss of vasomotor tone

Decreased baroreceptor sensitivity Thickening of SA node Decreased number of pacemaker cells Increased time of AV node conduction

Heart valve fibrosis and thickening

Increased lipid content in artery walls

Myocardial hypertrophy

Progressive thickening of arterial walls

Decreased ability to increase heart rate or BP in response to stressors

Prolonged PR interval

Predisposed to orthostatic hypotension**

Increased incidence of atherosclerotic events

Increased prevalence of arrhythmias

Haemodynamic alterations: Reduced cardiac output Increased BP Increased peripheral vascular resistance Decreased compliance of left ventricle Increased incidence of murmurs Extra heart sounds S3 and S4 *