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Cardiovascular response during postural change in the elderly.

I B Goldstein1, D Shapiro

  • 1Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.

Journal of Gerontology
|January 1, 1990
PubMed
Summary
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Older adults show blunted heart rate and blood pressure changes when standing. Behavioral techniques like handgrip and mental arithmetic may help prevent blood pressure drops in those with orthostatic hypotension.

Area of Science:

  • Cardiovascular Physiology
  • Gerontology

Background:

  • Orthostatic hypotension (OH) is a common condition in older adults, characterized by a significant drop in blood pressure upon standing.
  • Understanding the cardiovascular response to postural changes is crucial for managing OH and related symptoms like dizziness and falls.

Purpose of the Study:

  • To evaluate the heart rate and blood pressure responses during sitting, standing, and the transition between postures in healthy older adults.
  • To investigate the influence of behavioral maneuvers (handgrip and mental arithmetic) on these cardiovascular responses.

Main Methods:

  • A noninvasive beat-to-beat blood pressure tracking cuff was used to monitor cardiovascular parameters.
  • Forty healthy participants aged 60-76 years were studied under sitting and standing conditions.

Related Experiment Videos

  • The effects of handgrip and mental arithmetic tasks were assessed during the transition from sitting to standing.

    • Main Results:

    • Heart rate and blood pressure curves showed pronounced flattening immediately after standing compared to younger populations.
    • No significant sex differences were observed in the cardiovascular response to standing.
    • Only a small proportion of subjects (4/40) experienced a systolic blood pressure drop of ≥15 mmHg upon standing.
    • Both handgrip and mental arithmetic significantly altered the cardiovascular response during the sit-to-stand transition.

    Conclusions:

    • Healthy older adults exhibit attenuated cardiovascular reflexes upon standing, with no sex-specific differences.
    • Behavioral interventions show potential for mitigating orthostatic hypotension in susceptible individuals.
    • Training in behavioral techniques may offer a non-pharmacological approach to manage blood pressure regulation during orthostasis.