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Orthostatic hypotension in aging humans.

X Shi1, D W Wray, K J Formes

  • 1Departments of Integrative Physiology and Internal Medicine, University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas 76107, USA. xshi@hsc.unt.edu

American Journal of Physiology. Heart and Circulatory Physiology
|September 29, 2000
PubMed
Summary

Older adults experience orthostatic hypotension due to reduced heart rate response during challenges. Augmented vasoconstriction helps maintain blood pressure in elderly individuals during sustained stress.

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Area of Science:

  • Cardiovascular Physiology
  • Gerontology
  • Autonomic Nervous System Function

Background:

  • Orthostatic hypotension is common in older adults, often linked to autonomic dysfunction.
  • The role of vagal dysfunction in age-related orthostatic hypotension requires further elucidation.

Purpose of the Study:

  • To investigate the hypothesis that vagal dysfunction contributes to hypotension in older adults during orthostatic challenge.
  • To compare cardiovascular responses between healthy older and younger adults under lower body negative pressure (LBNP).

Main Methods:

  • Comparison of heart rate (HR) and mean arterial pressure (MAP) responses during LBNP in older and younger adults.
  • Pharmacological blockade of the parasympathetic and sympathetic nervous systems in younger adults to assess autonomic contributions.

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Main Results:

  • Older adults exhibited hypotension without tachycardia during LBNP onset, unlike younger adults who showed tachycardia without hypotension.
  • Parasympathetic blockade in younger adults diminished tachycardia and induced hypotension, while sympathetic blockade did not affect MAP.
  • Augmented vasoconstriction was observed in older adults during sustained LBNP, aiding blood pressure maintenance.

Conclusions:

  • Diminished heart rate response contributes to orthostatic hypotension in older adults at the onset of orthostatic stress.
  • Compensatory vasoconstriction plays a crucial role in maintaining blood pressure in the elderly during sustained orthostatic challenges.