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care costs due to spending on emergency care, hospital care, treatment, rehabilita-
tion etc. for the patients and the dependents (ii) employees requiring additional days
off in the workplace leading to lack of productivity, (iii) workplace errors and traffic
accidents leading to financial loss (iv) creating a strain in the financing for Medicaid
and Medicare that originates from tax dollars.
3 Why Is Cardiac Aging Important and What Does Cardiac
Aging Research Mean?
The American Heart Association has estimated that 83.6 million Americans to have
been diagnosed with at least one CVD [ 5 ]. Among that population, 42.2 million is
approximately 60 years of age or older, with the mortality rate of those above the
age of 75 being 66% [ 5 ]. Given that the elderly population (>65 years) of the United
States that numbered ~46.2 million in 2014 is estimated to be more than doubled to
98 million by the year 2060 [ 6 ], there is a huge risk in the emergence of a large seg-
ment of elderly individuals with age-associated cardiac dysfunction. Another
important reason as to why cardiac aging studies are critical is that there are no
uniform clinical characteristics of CVD and importantly, the course of CVD varies
and increases dramatically with advancing age [ 7 ]. Further, many of the physiologi-
cal alterations in the aging cardiovascular system and the underlying reasons are not
yet fully understood and solved. The cardiac aging research means (i) identifying
and quantifying potential areas of normative, age-related decline in the cardiac fit-
ness and determining if and how these changes are relevant in the pathological
aging process, (ii) address specific gaps in knowledge and construct improvised
heart disease knowledge utilizing the information derived from the interplay of
aging and what, and how, cardiac risk factors contribute to the development of
symptoms/heart failure, and (iii) glean crucial insights to improve the predictive
power of the disease and aid the scientific community to devise appropriate inter-
vention and management tools. Thus, relevant and rigorous evidence-based under-
standing of the aged heart is highly essential not only to inform the clinicians to
judiciously manage and treat the failing, senescent hearts but also to extend healthy
and independent living of the growing older population.
Although drug-based interventions against cardiac complications in the olderpeople is still a choice, for the group of aged individuals with borderline to mild
heart disease risk, due to their age-associated inherent decline in the body metabolic
and excretory functions, pharmacological interventions remain the second line of
treatment. Instead, lifestyle changes are the preferred choice of the prevention strat-
egy. Abundant data suggest that physical activity in combination with healthy
dietary consumptions and avoiding risk factors such as smoking, drinking etc., as a
lifestyle change for reducing the risk of cardiovascular disease (CVD) and coronary
heart disease (CHD) and improving the heart health [ 8 – 10 ]. In particular, exercise,
a term that includes both exercise training and physical activity has been shown to
elicit structural and functional benefits to the human cardiovascular system and
13 Cardiac Agingfi– Bene ts offiExercise, Nrf2 Activation andfiAntioxidant Signaling