Orthostatic hypotension in aging humans

Xiangrong Shi, D. Walter Wray, Kevin J. Formes, Hong Wei Wang, Patrick M. Hayes, Albert Yurvati, Martin S. Weiss, I. Philip Reese

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Abstract

We tested the hypothesis that hypotension occurred in older adults at the onset of orthostatic challenge as a result of vagal dysfunction. Responses of heart rate (HR) and mean arterial pressure (MAP) were compared between 10 healthy older and younger adults during onset and sustained lower body negative pressure (LBNP). A younger group was also assessed after blockade of the parasympathetic nervous system with the use of atropine or glycopyrrolate and after blockade of the β1-adrenoceptor by use of metoprolol. Baseline HR (older vs. younger: 59 ± 4 vs. 54 ± 1 beats/min) and MAP (83 ± 2 vs. 89 ± 3 mmHg) were not significantly different between the groups. During -40 Torr, significant tachycardia occurred at the first HR response in the younger subjects without hypotension, whereas significant hypotension [change in MAP (AMAP) -7 ± 2 mmHg] was observed in the elderly without tachycardia. After the parasympathetic blockade, tachycardiac responses of younger subjects were diminished and associated with a significant hypotension at the onset of LBNP. However, MAP was not affected after the cardiac sympathetic blockade. We concluded that the elderly experienced orthostatic hypotension at the onset of orthostatic challenge because of a diminished HR response. However, an augmented vasoconstriction helped with the maintenance of their blood pressure during sustained LBNP.

Original languageEnglish
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume279
Issue number4 48-4
Publication statusPublished - 7 Dec 2000

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Keywords

  • Atropine
  • Glycopyrrolate
  • Lower body negative pressure
  • Metoprolol
  • Tachycardiac response
  • Vagal dysfunction

Cite this

Shi, X., Wray, D. W., Formes, K. J., Wang, H. W., Hayes, P. M., Yurvati, A., ... Reese, I. P. (2000). Orthostatic hypotension in aging humans. American Journal of Physiology - Heart and Circulatory Physiology, 279(4 48-4).