Sex-dependent deterioration of cardiac function and molecular alterations in age- and disease-associated RAGE overexpression

[Biological mechanisms of aging in the cardiovascular system]

Cardiovascular diseases, which are at the end of a spectrum of degenerative processes, are one of the leading causes of death worldwide. A causal contribution to these and many other diseases is made by key biological aging mechanisms that have been summarized as the hallmarks of aging. These include accumulation of macromolecular damage, epigenetic changes, impaired proteostasis, telomere shortening, mitochondrial dysfunction, cellular senescence, inflammatory reactions, altered metabolism, impaired cellular communication and changes in the stem cell niche. In the cardiovascular system, oxidative and glycative stress are particularly important as sources of macromolecular damage. These induced insidious changes reduce the resilience and resistance of the heart and vessels to stress, ultimately leading to functional impairments and diseases. A possible novel approach, which does not aim at an intervention against the classical cardiovascular diseases but against the hallmarks of aging, and is termed geroscience, provides valuable concepts but still has to prove itself in the future.