Chronic Heart Failure in Elderly: Focus on Inflammation and Arterial Stiffness

The medical and social significance of chronic heart failure (CHF) is determined by its high prevalence and its pronounced impact on health status, work capacity, and life expectancy of the population. The global increase in the number of individuals with cardiovascular diseases (CVD), including elderly patients, is accompanied by a steady rise in the prevalence of CHF. Measures aimed at combating age-associated diseases in a large population of older adults in the coming decades will have a substantial impact on healthcare systems and the economy. At present, inflammation is considered one of the key factors in the development of CHF, contributing to the initiation, progression, and formation of complications of this disease. In patients with CHF, regardless of its etiology, increased concentrations of proinflammatory cytokines are observed, which represent important mediators of the immune system. Since aging is associated with both frailty and CHF, it can be assumed that disturbances in immunological responses leading to chronic inflammation constitute a common pathophysiological basis for aging and CHF. As CHF progresses, inflammatory mediators, including cytokines, become part of the trigger mechanism of maladaptive cardiovascular responses to stress factors and play an important role in the pathogenesis of CHF in elderly patients. In combination with the generation of reactive oxygen species, a number of processes occur, including inflammation, calcification, elastin cross-linking, and collagen accumulation, leading to increased arterial stiffness. Vascular aging and the associated arterial stiffness are characterized by structural and functional changes in the vascular wall, resulting in microvascular dysfunction and target organ damage. This review article is devoted to the analysis of scientific research data addressing the role of inflammation and arterial stiffness in CHF among elderly individuals.