​​​​​Pulse Waveform of a 80 year old person

In the elderly, further arterial stiffening cause the reflected wave to return much faster and gives rise to a “shouldering” at the primary wave; and coincide very close to the systolic peak, resulting in an augmented wave. The heart now needs to contract even harder (to overcome the oncoming reflected wave) and for a longer period. At the same time, coronary artery perfusion is further compromised.