Regional anesthesia for acute pain management in elderly patients

Table 5 Cardiovascular changes associated with the aging process[12]

Cardiac changes	Coronary artery disease due to atherosclerosis
	Changes in CNS innervations of the cardiovascular system: increase in sympathetic and decrease in parasympathetic activity
	Diminished response to beta-receptor stimulation
	Increase in apoptosis resulting in muscle mass loss, compensatory hyperplagia of remaining cells, abnormal cardiac function that can eventually lead to diastolic and systolic heart failure
	Increase in microtubule component of cytoskeleton of cardiocytes results in contraction dysfunction
Vascular system changes	Decreased blood flow due to increased cell adherence, micro-thrombogenic events, atherosclerosis
	Increased vasoconstriction and vascular wall stiffening
	Impaired endothelium integrity and ability to repair

CNS: Central nervous system.