Effects of Gender and Aging on Differential Autonomic Responses to Orthostatic Maneuvers

Barantke, Melanie; Krauss, Timothy; Ortak, Jasmin; Lieb, Wolfgang; Reppel, Michael; Burgdorf, Christof; Pramstaller, Peter P.; Schunkert, Heribert; Bonnemeier, Hendrik

doi:10.1111/j.1540-8167.2008.01257.x

Cited by 99 publications

(97 citation statements)

References 28 publications

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“…This maneuver induces a cardiac sympathetic modulation, which is increased when assessed by a linear methodology, i.e., spectral analysis (23). The same effect is also observed during graded head-up tilt (passive maneuver) by using non-linear methods, i.e., symbolic analysis (22).…”

mentioning

confidence: 78%

Spectral and symbolic analysis of the effect of gender and postural change on cardiac autonomic modulation in healthy elderly subjects

Perseguini

Takahashi

Rebelatto

et al. 2011

Braz J Med Biol Res

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mentioning

confidence: 78%

Spectral and symbolic analysis of the effect of gender and postural change on cardiac autonomic modulation in healthy elderly subjects

Perseguini

Takahashi

Rebelatto

et al. 2011

Braz J Med Biol Res

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“…25 Furthermore, it should be noted that the orthostatic increase in HR poorly reflects adrenergic response in old individuals. 26 The current study presents some limitations. In older frail subjects, cardiovascular mortality can be misdiagnosed.…”

Section: Discussionmentioning

confidence: 99%

Evidence for a Prognostic Role of Orthostatic Hypertension on Survival in a Very Old Institutionalized Population

et al. 2016

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Abstract-In old individuals, regulation of blood pressure during postural changes is impaired. Several studies have assessed the clinical impact of orthostatic hypotension (OHypoT) during the aging process. By contrast, the prevalence and prognostic role of the increase in blood pressure in upright position (orthostatic hypertension, OHyperT) in old adults remain unknown. We investigated the association of OHyperT with cardiovascular morbidity and mortality in a population of old institutionalized subjects. A 2-year follow-up longitudinal study was conducted on 972 subjects ( In conclusion, in a old frail population, the increase in systolic blood pressure during upright position occurs frequently and is associated with higher cardiovascular morbidity and mortality independently of sitting blood pressure levels and major comorbidities. Health professional should take into account not only the decrease but also the increase in blood pressure when standing up. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00901355.

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“…Furthermore, our data showed a higher RS ratio in men than in women, supporting a possible difference in postural cardiac autonomic modulation between men and women (43). The RS ratio is the result of a transient decrease in blood pressure and an increase in heart rate following translocation of blood due to active standing from a supine position.…”

Section: Discussionmentioning

confidence: 56%

“…In healthy subjects the heart rate and blood pressure reach normal homeostatic levels after approximately 30 s of standing (44). Healthy women have demonstrated lower sympathetic responsiveness in the supine position and greater parasympathetic responsiveness in the upright position, resulting in a lower orthostatic tolerance compared with men (43). The decrease in systolic blood pressure during standing has been used as a measure of sympathetic dysfunction; however, the change in blood pressure develops late in diabetic neuropathy compared with the results of heart rate-based tests used in this study (30).…”

Section: Discussionmentioning

confidence: 88%

Glycemic Variability Is Associated With Reduced Cardiac Autonomic Modulation in Women With Type 2 Diabetes

et al. 2015

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OBJECTIVETo investigate the sex differences in cardiac autonomic modulation in patients with newly diagnosed type 2 diabetes and to determine whether cardiac autonomic modulation is associated with glycemic variability. RESEARCH DESIGN AND METHODSWe investigated a cohort consisting of 48 men and 39 women with non-insulin-treated type 2 diabetes and a known duration of diabetes <5 years. All patients were equipped with a continuous glucose monitoring sensor for 3 days, and the mean amplitude of glycemic excursions (MAGE) was calculated to obtain individual glycemic variability. Cardiac autonomic modulation was quantified by analysis of heart rate variability (HRV) in time and frequency domains and during cardiovascular reflex tests (response to standing [RS], deep breathing [expiration-inspiration], and Valsalva maneuver). RESULTSSex differences in age-and heart rate-adjusted HRV measures were observed in both active and passive tests. Low frequency (LF; P = 0.036), LF/high frequency (HF; P < 0.001), and RS (P = 0.006) were higher in men, whereas expiration-inspiration (P < 0.001), but not HF, was higher in women. In women, reduced cardiac autonomic modulation as assessed by the standard deviation of normal-to-normal intervals (P = 0.001), the root mean square of successive differences (P = 0.018), LF (P < 0.001), HF (P = 0.005), total power (P = 0.008), RS ratio (P = 0.027), and expiration-to-inspiration ratio (P = 0.006) was significantly associated with increased glycemic variability as assessed by MAGE. This was not the case in men. The association in women persisted in a multivariate regression analysis controlling for weight, mean heart rate, blood pressure (systolic), and triglycerides. CONCLUSIONSIn patients with newly diagnosed and well-controlled type 2 diabetes, increased glycemic variability was associated with reduced cardiac autonomic modulation in women but not in men.Evidence points toward a cardioprotective effect of sex hormones (estrogen and progesterone) in premenopausal women, one possibly mediated through improved cardiac autonomic balance both centrally and peripherally by suppression of sympathetic tone and elevation of parasympathetic tone (1,2). The presence of diabetes has been shown to reduce the sex difference and minimize cardioprotection in

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Effects of Gender and Aging on Differential Autonomic Responses to Orthostatic Maneuvers

Abstract: There are significant differences in postural cardiac autonomic modulation between men and women, and the degree of autonomic response to orthostatic maneuvers varies with normal aging. These results may explain gender- and age-related differences in orthostatic tolerance.

Cited by 99 publications

References 28 publications

Spectral and symbolic analysis of the effect of gender and postural change on cardiac autonomic modulation in healthy elderly subjects

Spectral and symbolic analysis of the effect of gender and postural change on cardiac autonomic modulation in healthy elderly subjects

Evidence for a Prognostic Role of Orthostatic Hypertension on Survival in a Very Old Institutionalized Population

Glycemic Variability Is Associated With Reduced Cardiac Autonomic Modulation in Women With Type 2 Diabetes

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