Cardiovascular Aging and Exercise: Implications for Heart Failure Prevention and Management

A demographic shift toward an aging population is occurring worldwide. Commensurate with this trend, age-related diseases are also rising. Although aging is an immutable part of life, biological aging is a highly heterogeneous process influenced by health-related behaviors, genetics, and the environment. The biological effects of aging are evident across all organ systems. Some individuals demonstrate an accelerated aging phenotype, which is associated with substantial morbidity and mortality. Moreover, common cardiovascular conditions, such as heart failure with preserved ejection fraction, can be conceptualized as a consequence of accelerated aging. Physical activity and exercise training modify the biological effects of accelerated aging considerably. They are associated with various salutary benefits and have emerged as potent therapeutics in disease states characterized by the accelerated aging phenotype. In this state-of-the-art review, we discuss the age-related changes observed in cardiovascular and peripheral tissues, the implications of age acceleration, and the effectiveness and mechanisms of physical activity and exercise training to curb the deleterious effects of aging and improve outcomes.