American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What cardiovascular change occurs with aging?

1. Increased contractility of the myocardium

2. Decreased filling pressures in the heart

3. Increased arterial stiffness

4. Decreased sensitivity to arrhythmias

The correct answer is: Increased arterial stiffness

With aging, one of the significant cardiovascular changes observed is increased arterial stiffness. As individuals age, the elastic fibers within the arterial walls degrade, leading to a reduced ability for arteries to expand and contract. This stiffness contributes to higher systolic blood pressure and a wider pulse pressure, both of which can have downstream effects on cardiovascular health. Increased arterial stiffness is associated with various conditions, including hypertension and increased left ventricular workload, which can influence the overall function of the heart and increase the risk of cardiovascular events. The other choices present different phenomena associated with heart function. Increased contractility of the myocardium would imply a stronger heart muscle, which typically does not occur with aging; instead, contractility often decreases. Decreased filling pressures in the heart are not a primary change seen in aging; in fact, the opposite may occur due to increased stiffness. A decreased sensitivity to arrhythmias is not a reported effect of aging; older individuals often exhibit an increased risk for arrhythmias due to other factors such as structural heart changes and altered conduction pathways.