It is not difficult to understand the often held misconception that heart disease is part of ‘‘normal aging’’ and that overall cardiovascular function declines with increasing age. This rapidly growing portion of the population often does have heart disease, with hypertension, coronary artery disease, and heart failure being three conditions commonly diagnosed in many elderly patients. Nonetheless, it is not the case that heart disease and impaired cardiac function is a sine que non of the aging process. Healthy elderly persons have normal left ventricular systolic function at rest. Importantly, there are certain cardiovascular changes that occur with aging throughout the animal kingdom which are important to recognize and which are described below. Knowledge of the cardiovascular changes that occur with aging are important for several reasons.