Why do older people have a higher tolerance for heart attacks?
A pleasure to be here again for all of you, hoping you had a good weekend, and that next week will be very good for you too.
As you read in the title, the subject of this post is quite particular, I want to give an answer to that question: Why do older people have more tolerance to heart attacks?, and all this has its basis in a complex process called Angiogenesis.
Surely you have heard or seen older people who have survived a heart attack, but instead, young people who suffer a heart attack ends up being this fulminant, and does not survive, do you want to know what is the reason for this?, if so I invite you to continue reading that what I am going to expose you sure you are interested.
What is this Angiogenesis?, I will begin by saying that like most medical words is a compound, on the one hand is genesis, which means creation and on the other hand angio, which alludes to blood vessel.
Angiogenesis, then, is the process by which *new blood vessels are *formed from existing ones. It is an important process in the development of the embryo and fetus, as well as in the repair of damaged tissues and the healing of wounds in the body.
In the embryonic process, it is self-explanatory, since in reality everything is in the process of generation and growth, but there are other conditions in the human being where this process is activated, such as when there is an injury of some tissue, or even in cancer it is also something that is generated in a habitual way, but in this case in a very negative way, and this is the subject of the next post, which I am sure you will also be interested to know about it.
I would like to explain in a simple way how this process is, how it is generated, how it is produced, because it is crucial to understand later why older people can tolerate with greater probability a heart attack than a young person. The following is a step-by-step description:
Activation: Angiogenesis is initiated by the activation of specific cells, such as endothelial cells, that line pre-existing blood vessels.
Degradation of the extracellular matrix: Activated cells secrete enzymes that degrade the extracellular matrix surrounding the blood vessels, creating a pathway for the growth of new vessels.
Proliferation:* Endothelial cells divide and migrate to the area where new vessel formation is required.
Differentiation: Endothelial cells organize into tubes and differentiate into functional blood vessels.
Formation of new vessels: Tubes organize and fuse to form new blood vessels.
Stabilization: New blood vessels are stabilized through the formation of muscle cell layers and extracellular matrix production.
Remodeling: New blood vessels are remodeled to improve the efficiency of blood circulation.
This process of angiogenesis is regulated by a number of growth factors and proteins, such as vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF) and transforming growth factor beta (TGF-β), which stimulate or inhibit the growth of new blood vessels.
As you can see it is a highly organized process, which happens one step after another, finely coordinated by different molecules. The detail here that can shed light on the answer to the question that serves as the objective of this post is precisely the process of initiation of angiogenesis.
For this to occur it must trigger the release of specific substances at the site where blood vessels already exist. Speaking specifically of the heart, it is well known that it is highly irrigated by both veins and arteries, and it is these that fail when a cardiac infarction occurs, specifically the arteries, which are the ones that carry oxygenated blood.
Let us remember that in the process of our lives, and especially in people who have had an unhealthy diet, rich in the so-called trans fats, those that stick to the walls of the arteries and end up forming atheroma plaques, with the passage of time decrease the light of the blood vessel, which prevents the circulation of the amount of blood necessary for the requirements of the organ. It is here that the process of angiogenesis is started, which continues for decades, and this is how older people have accessory blood vessels in their hearts.
These additional blood vessels are the ones that supply blood to the cardiac area where the primary blood vessel is no longer sufficient. With the passage of time, if that first blood vessel becomes completely obstructed and the passage of blood through it ceases, a blood vessel will have already been generated (with the passage of time) that will allow that cardiac area not to be absolutely without blood supply, and at the same time oxygen and other nutrients.
On the contrary, in younger people, who have not had the time to generate this "accessory blood vessel", if a cardiac artery becomes obstructed, either by a blood clot or by a fatty embolus, it will be practically impossible to survive a cardiac infarction.
I hope I have provided an answer in this publication to the question:
Why do older people have a higher tolerance for heart attacks?.
Which arose from a question I was asked by a lady, who did not understand why a young person, who is supposed to be stronger than an older person, and is generally healthier, would not survive a heart attack, but an older adult could eventually do so.
I also hope you have enjoyed this reading, if you have anything to add or ask, I invite you to leave it in the comments, and that way we could all benefit. And don't forget, in the next post I will be talking about the relationship of angiogenesis with other diseases.
Truth is I never even knew old people have a stronger tolerance towards heart attacks, I thought they will be more subjected to heart attack than younger people, thanks for the post.
Yes, it is really strange, but it is a reality.
Hello, your publication is very interesting, it is a question that many people ask themselves, and I think you have explained it very well. Our body is very wise and always finds a way to improve, to create and to make our lives a little easier.
Of course, without forgetting that we must also have good habits so that everything works as it should, because this is another big mistake that many make, not taking care of themselves throughout their lives. Excelent topic.
Thanks for comment. And yes, of course, it is difficult to see something that is more complex than the human body on a biological level.
Very interesting post. I have a couple of questions though -
The statistics I am aware if suggest that in-hospital mortality due to myocardial infarction increases with age.
Source: https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.116.003443
The trend is same for both obstructive and non-obstructive heart attacks. Can you shed some light on data/study that shows that fatality post myocardial infarction is higher in younger people? This is definitely interesting in itself, and would be helpful to look at data.
My second question is regarding angiogenesis itself. Mostly, angiogenesis is not very perfect on older individuals. Furthermore, a lot of angiogenesis happens in damaged sites. Are the additional blood vessels in heart associated with damage? What methods/parameters were used to compare and count these blood vessels?
Thanks and regards
Hello @apineda,
It is great to pass through again and i am happy to say that yes i loved your post, every bit of it, it was enlightening. I think this thought has occurred to me before why it happens like that but i never bothered to look more into it probably because as at that time i had lots of assignments to think about.
I am glad i came across this too and i have the solution to that unanswered question now. accessory vessels saves lives haha. It was a pleasurable read, thanks for sharing and i do wish you a fruitful week. Cheers!
Thank you very much for commenting, the truth is that it is a topic that I have liked to develop.
do you know exactly why the angiogenesis rate in older people is lower? is there any association with specific genes?
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