An understanding of the effects of aging upon the cardiovascular system assumes greater clinical importance as the population ages. Animal studies demonstrate prolonged tension development, impaired relaxation, and diminished response to receptor-mediated inotropic interventions in the cardiac muscle of senescent animals. Ventricular afterload is augmented at rest and increases during exercise through age-related alterations in peripheral arteries. Increased impedance to ejection may result in the modest concentric left ventricular hypertrophy seen in the elderly. Despite changes in cardiovascular function, resting and exercising cardiac outputs are well maintained in healthy elderly individuals who are free of occult coronary artery disease. The reduction in maximal oxygen consumption appears secondary to altered peripheral oxygen utilization rather than to cardiac causes.