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NBME 20 Answers

nbme20/Block 2/Question#23

Which of the following changes in the ...

Increased basal systolic blood pressure

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aging results in increased arterial stiffness (change in Extra Ccellular Mmatrix composition - decreased elastin, increased collagen deposition); ISH is responsible for 60-80% of HTN cases in patients > 60. Also, decreased compliance as a result of aging causes increased pulse pressure

rio19111  why not dev. of coronary atherosclerosis? +  
pakimd  @rio19111 i think the Q stem is asking in absence of any lesions of blood vessels; the number and severity of which increase with age. So with normal aging SBP should increase in isolation which may then result in the development of coronary atherosclerosis- if that makes sense +  
chandlerbas  aging causes decreased compliance in large arteries: (1) accumulation of collagen and calcium (2) degraded elastin and large arteries accumulation and it also may have something to do with lipofuschin +