SUMMARY Blood pressure, heart rate, forearm vascular resistance, and hormonal responses to graded lower body negative pressure were investigated in 15 hypertensive men younger than 55 years of age (mean age, 44 ± 2 years) and 13 comparably hypertensive men older than 55 years of age (mean age, 63 ± 2 years). Baseline forearm vascular resistance was greater in the elderly group compared with the younger hypertensive men. However, forearm vascular resistance responses to selective unloading of low pressure cardiopulmonary baroreceptors were similar in the two groups. This finding suggests that normal vascular responses to the unloading of cardiopulmonary baroreceptors are preserved in subjects with advancing age and mild to moderate hypertension. Baseline plasma norepinephrine levels, as well as norepinephrine responses to lower body negative pressure, were comparable in the two groups. This finding suggests that, unlike normotensive subjects, essential hypertensive subjects do not have an age-related increase in sympathetic nervous system activity. (Hypertension 10: 274-279, 1987)
KEY WORDS • cardiopulmonary baroreceptors • aging • norepinephrine A T H E R O S C L E R O S I S and other senescent/ \ changes in the carotid sinus region and the A. \ . aortic arch area have been reported to lead to impairment of high pressure baroreceptor function. '~3 That high pressure baroreceptor sensitivity is diminished with aging is evidenced by decreased bradycardia in response to pressor doses of phenylephrine.' Baroreceptor reflexes exert control over medullary vasomotor centers to modulate sympathetic nervous system activity, and the decline of high pressure baroreceptor and, perhaps, low pressure cardiopulmonary baroreceptor sensitivity 45 with aging probably contributes to the increased secretion of norepinephrine (NE) reported in normotensive subjects.6 " 10 This concept is supported by the observation that simultaneously increased sympathetic activity in several vascular beds occurs during inhibition of high pressure baroreceptor reflex activity." Furthermore, decreased high pressure baroreceptor reflex sensitivity is a characteristic observed in young to middle-aged patients with essential hypertension, 12 in whom the extent of the reflex abnormality is correlated with elevations of plasma NE. However, several recent studies 13 ' 14 have reported that plasma NE increases with age in normotensive subjects but not in subjects with essential hypertension. These recent observations suggest the possibility that receptor sensitivity of low pressure cardiopulmonary baroreceptors may not be diminished with increasing age in essential hypertensive persons.The present study was designed to compare the hormonal and hemodynamic responses in middle-aged and elderly patients with essential hypertension following selective activation of low pressure cardiopulmonary reflexes through graded lower body negative pressure (LBNP).
Subjects and MethodsTwenty-eight men with mild to moderate essential hypertension were studied. Fifteen o...