New discoveries in the field of geroscience could transform management strategies for cardiovascular disease in older adults, with the potential to mitigate premature aging, reduce health care disparities and improve population health spans, according to a recently published JACC Scientific Statement.

Daniel E. Forman, MD, FACC, et al., propose that geroscience, the study of therapeutics that target the fundamental mechanisms of aging to delay or avert age-related chronic diseases, should interest cardiovascular clinicians because: 1) geroscience-based therapies that target mechanisms upstream of cardiovascular disease may help decrease its prevalence and mortality; 2) gerotherapeutics might improve prognosis by preventing or ameliorating comorbidities and frailty in patients with cardiovascular disease; 3) identifying individuals with accelerating aging may allow targeting during the early stages of cardiovascular disease, when gerotherapeutics may be more effective.

The authors break down the main aging resilience mechanisms targeted by gerotherapeutics and their connection to cardiovascular disease and other geriatric syndromes. These “hallmarks” of aging include genomic damage, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem-cell exhaustion, dysbiosis and telomere shortening. They also present both nonpharmacologic and pharmacologic interventions using gerotherapeutics to manage cardiovascular disease.

Forman, et al., additionally touch on the role geroscience may play in addressing health inequities, acknowledging the significant impact social determinants of health (SDOH) have on cardiovascular disease. “As SDOH disparities can strongly influence biological mechanisms of aging, geroscience-based pharmacologic interventions that target prevention of CVD may prevent other SDOH-accelerated chronic diseases as well,” state the authors.

Approaches informed by geroscience will help medical practitioners increase health span by mitigating disease and frailty throughout all stages of life, and according to the statement authors, cardiovascular specialists are primed to apply gerotherapeutics to their practice, “as they have already embraced concepts of primary and secondary prevention, and cardiovascular conditions contribute enormously to the challenges of older age.”

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Geriatric Cardiology, Genetic Arrhythmic Conditions

Keywords: Epigenesis, Genetic, Nutrients, Genomics, Prognosis, Chronic Disease, Aging, Premature, Aging, Dysbiosis, Prevalence, Cardiovascular Diseases, Frailty, Proteostasis, Telomere Shortening, Aged

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