Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects

Laitinen, Tomi; Niskanen, Leo; Geelen, G.; Länsimies, Esko; Hartikainen, Juha

doi:10.1152/japplphysiol.00444.2003

Cited by 147 publications

(140 citation statements)

References 58 publications

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“…This may reflect age-related attenuation of NO production and cardiovascular autonomic function (35). The lack of response on MVR in the diabetic patients in the present study might also be due to even more pronounced cardiovascular autonomic alterations compared with the middle-aged control subjects.…”

Section: Discussionmentioning

confidence: 58%

Impact of Type 2 Diabetes on Nitric Oxide and Adrenergic Modulation of Myocardial Perfusion

et al. 2007

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Type 2 diabetic patients are characterized by a reduced adenosine-induced hyperemic myocardial perfusion, which may contribute to their increased cardiovascular morbidity. We hypothesized that the reduced hyperemia can be explained by functional changes in endothelial or autonomic nervous regulation. In 12 type 2 diabetic patients without signs of ischemic heart disease and 14 age-matched control subjects, myocardial perfusion was measured at rest, during adenosine, and during adenosine and ␣-receptor blockade (phentolamine) using positron emission tomography on two separate days: 1) with, and 2) without nitric oxide (NO) inhibition with N G -nitro-L-arginine methyl ester. Myocardial perfusion during adenosine was lower in type 2 diabetic patients compared with control subjects (P ‫؍‬ 0.05). No significant effect of NO inhibition on myocardial perfusion during adenosine was found in any of the groups. In control subjects, ␣-receptor blockade increased hyperemic myocardial vascular resistance during NO inhibition, whereas no effect was observed in type 2 diabetic patients. At rest, a significant correlation was observed between rate-pressure product and myocardial perfusion in control subjects. NO inhibition and type 2 diabetes abolished this correlation. Endothelial and cardiac autonomic nerve function seems to play only a minimal role in the reduced hyperemic myocardial perfusion in type 2 diabetic patients. However, the linear correlation between resting perfusion and cardiac work appears to be abolished in type 2 diabetes and during NO synthase inhibition. Diabetes 56: 468 -475, 2007

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Section: Discussionmentioning

confidence: 58%

Impact of Type 2 Diabetes on Nitric Oxide and Adrenergic Modulation of Myocardial Perfusion

et al. 2007

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“…Earlier studies described an increase of SAP mean [7,48] and SAP variability with aging [10][11][12][49][50][51]. These results have been interpreted as a consequence of the increase of sympathetic activity and/or modulation directed to the vessels with age [48].…”

Section: Complexity Of the Sap Variability At Rest: Aging And Gender mentioning

confidence: 83%

“…These results have been interpreted as a consequence of the increase of sympathetic activity and/or modulation directed to the vessels with age [48]. However, a modified cardiac reserve [7], changes of the structure of the arteries (i.e., increased stiffness, decreased compliance, and endothelial dysfunction) [52], and changes of diastolic filling and increases in collagen in the left ventricle might play a role in the modification of SAP mean and variance with age [7,31].…”

Section: Complexity Of the Sap Variability At Rest: Aging And Gender mentioning

confidence: 99%

“…These findings are in agreement with those reported in [18,57,58] and can be explained by the reduced effect of the change of posture on the cardiovascular variables with age. The progressively limited influence of the orthostatic challenge has been attributed to the impairment of beta-adrenergic receptor stimulation [7,31], reduced efficiency of post-synaptic-adrenergic signaling [52], reduced vagal autonomic modulation to the sinus node [3,[5][6][7][8][9]59], reduced sympathetic modulation to the vessels [48], and decreased baroreflex efficiency [48,58,60].…”

Section: Individual Changes In the Complexity Of Hp And Sap Variabilimentioning

confidence: 99%

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Effect of the Postural Challenge on the Dependence of the Cardiovascular Control Complexity on Age

Catai

Takahashi

Perseguini

et al. 2014

Entropy

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Short-term complexity of heart period (HP) and systolic arterial pressure (SAP) was computed to detect age and gender influences over cardiovascular control in resting supine condition (REST) and during standing (STAND). Healthy subjects (n = 110, men = 55) were equally divided into five groups (21-30; 31-40; 41-50; 51-60; and 61-70 years of age). HP and SAP series were recorded for 15 min at REST and during STAND. A normalized complexity index (NCI) based on conditional entropy was assessed. At REST we found that both NCIHP and NCISAP decreased with age in the overall population, but only women were OPEN ACCESSEntropy 2014, 16 6687 responsible for this trend. During STAND we observed that both NCIHP and NCISAP were unrelated to age in the overall population, even when divided by gender. When the variation of NCI in response to STAND (ΔNCI = NCI at REST-NCI during STAND) was computed individually, we found that ΔNCIHP progressively decreased with age in the overall population, and women were again responsible for this trend. Conversely, ΔNCISAP was unrelated to age and gender. This study stresses that the complexity of cardiovascular control and its ability to respond to stressors are more importantly lost with age in women than in men.

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“…Investigations of men and women from 23-77 yr of age indicated that the heart rate response to tilt was reduced with aging, but vascular responses appeared to be enhanced to protect against low blood pressure (17,32). A study that focused on postmenopausal women also reported a reduction in arterial baroreflex responsiveness and heart rate control characterized by greater sympathetic and reduced parasympathetic modulation (33).…”

mentioning

confidence: 99%

Hemodynamics and brain blood flow during posture change in younger women and postmenopausal women compared with age-matched men

Edgell

Robertson

Hughson

2012

Journal of Applied Physiology

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Edgell H, Robertson AD, Hughson RL. Hemodynamics and brain blood flow during posture change in younger women and postmenopausal women compared with age-matched men. J Appl Physiol 112: 1482-1493, 2012. First published February 23, 2012 doi:10.1152/japplphysiol.01204.2011.-Increased incidence of orthostatic hypotension and presyncopal symptoms in young women could be related to hormonal factors that might be isolated by comparing cardiovascular and cerebrovascular responses to postural change in young and older men and women. Seven young women, 11 young men, 10 older women (Ͼ1 yr postmenopausal, no hormone therapy), and 9 older men participated in a supine-to-sit-to-stand test while measuring systemic hemodynamics, end-tidal PCO2, and blood flow velocity of the middle cerebral artery (MCA). Women had a greater reduction in stroke volume index compared with age-matched men (change from supine to standing: young women: Ϫ22.9 Ϯ 1.6 ml/m 2 ; young men: Ϫ14.4 Ϯ 2.4 ml/m 2 ; older women: Ϫ17.4 Ϯ 3.3 ml/m 2 ; older men: Ϫ13.8 Ϯ 2.2 ml/m 2 ). This was accompanied by offsetting changes in heart rate, particularly in young women, resulting in no age or sex differences in cardiac output index. Mean arterial pressure (MAP) was higher in older subjects and increased with movement to upright postures. Younger men and women had higher forearm vascular resistance that increased progressively in the upright posture compared with older men and women. There was no difference between sexes or ages in total peripheral resistance index. Women had higher MCA velocity, but both sexes had reduced MCA velocity while upright, which was a function of reduced blood pressure at the MCA and a significant reduction in end-tidal PCO2. The reductions in stroke volume index suggested impaired venous return in women, but augmented responses of heart rate and forearm vascular resistance protected MAP in younger women. Overall, these results showed significant sex and age-related differences, but compensatory mechanisms preserved MAP and MCA velocity in young women. cerebrovascular; sex; age; orthostatic ORTHOSTATIC HYPOTENSION (a condition that sometimes leads to fainting) is an important and sometimes dangerous condition that particularly affects young women during daily life, as reflected by admission to emergency rooms (51). It has been speculated that female sex hormones might modulate reflex neural or vascular properties, resulting in the greater incidence of orthostatic hypotension in young women (5,14,15,52,69). An additional indication of impaired orthostatic responses in women includes the observation that women have a greater propensity towards postural orthostatic tachycardia syndrome (18, 60).Contrary to observations for young women, clinical evidence supports the concept that orthostatic hypotension occurs less frequently in women ages 40 -60 yr (many of whom could be postmenopausal) (51). Investigations of men and women from 23-77 yr of age indicated that the heart rate response to tilt was reduced with aging, but vascular responses a...

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Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects

Cited by 147 publications

References 58 publications

Impact of Type 2 Diabetes on Nitric Oxide and Adrenergic Modulation of Myocardial Perfusion

Impact of Type 2 Diabetes on Nitric Oxide and Adrenergic Modulation of Myocardial Perfusion

Effect of the Postural Challenge on the Dependence of the Cardiovascular Control Complexity on Age

Hemodynamics and brain blood flow during posture change in younger women and postmenopausal women compared with age-matched men

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