Ambulatory blood pressure and its response to exercise in the elderly

Thirty-three elderly subjects--9 hypertensives, 15 with a history of unexplained falls and 9 asymptomatic volunteers, underwent 24 h continuous intra-arterial ambulatory blood pressure (BP) monitoring under controlled conditions. During this time their response to standardized exercise and baroreflex activity were assessed. The casual BP of the hypertensives was significantly higher than that of the other groups, but during ambulatory BP monitoring, the BP of all 3 groups fell and indeed diastolic BP (DBP) of the hypertensives and fallers was similar during the awake period of monitoring whilst all 3 groups had similar DBP during sleep. Variability of awake and sleep BP was similar. During exercise all 3 groups sustained similar increases in systolic BP (SBP) but the increase in DBP was lower in the volunteers. Baroreflex activity was similar in all groups. The results show little difference between the groups other than those pre-selected by casual BP measurement, and the parameters recorded reflect the process of ageing rather than specific abnormalities associated with the elderly hypertensives or fallers.