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Autonomic function is impaired in elderly stroke survivors.
Andrew McLaren1, Simon Kerr, Louise Allan
1Institute for Ageing and Health, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE. a.t.mclaren@ncl.ac.uk
Stroke
|April 2, 2005
Summary
Older stroke survivors show impaired autonomic function long after recovery. This autonomic dysfunction may increase mortality risk in this population.
Area of Science:
- Cardiovascular autonomic function
- Neurology
- Geriatrics
Background:
- Autonomic dysfunction is frequent in acute stroke.
- Long-term effects of stroke on autonomic function, especially in older adults, are not well understood.
Purpose of the Study:
- To investigate long-term autonomic function after stroke in elderly patients.
- To compare autonomic function in older stroke survivors versus age-matched controls.
Main Methods:
- Cross-sectional case-control study.
- 76 non-demented stroke patients and 70 community-living controls (age > 75 years).
- Assessed autonomic function using heart rate variability (HRV) power spectral analysis and cardiovascular autonomic reflex tests (CART).
Main Results:
- Stroke patients exhibited reduced HRV total and low-frequency spectral densities.
- Impaired baroreflex sensitivity (alpha low-frequency) was observed in stroke survivors.
- Lower heart rate variation during respiration, Valsalva ratio, and blood pressure overshoot were noted in stroke patients, alongside an exaggerated blood pressure response to isometric exercise.
Conclusions:
- Cardiovascular autonomic function remains impaired long after stroke in older survivors.
- This persistent autonomic impairment may elevate the risk of all-cause and cardiovascular mortality.