Skip to main content
Erschienen in: Clinical Autonomic Research 5/2015

01.10.2015 | Research Article

Sex and age effects on cardiovascular autonomic function in healthy adults

verfasst von: Jean-Pierre Ndayisaba, Alessandra Fanciulli, Roberta Granata, Susanne Duerr, Florian Hintringer, Georg Goebel, Florian Krismer, Gregor K. Wenning

Erschienen in: Clinical Autonomic Research | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To determine the effects of sex and age on cardiovascular autonomic parameters in healthy adults as assessed by Finapres (finger arterial pressure) method and prolonged head-up tilt (HUT).

Methods

We enrolled 81 healthy volunteers (41 females, 40 males, 18–74 years) for extensive cardiovascular autonomic function testing including blood pressure (BP) recordings, electrocardiography, and impedance cardiography at rest, under 60° HUT for 45 min, active standing for 5 min, Valsalva maneuver, and deep breathing (DB). Mean values and orthostatic changes, i.e., differences to baseline, of heart rate (HR), systolic and diastolic BP, stroke volume (SV), and total peripheral resistance (TPR), as well as DB ratio and Valsalva ratio were calculated. A generalized linear model (extended by generalized estimating equations) was used to assess sex- and age-related differences.

Results

Mean HR at rest was higher in women than in men (p = 0.035). In men, we observed significantly higher mean BP at rest (p < 0.001 systolic and p = 0.004 diastolic) and during HUT (p = 0.001 systolic and p < 0.001 diastolic), mean TPR at rest (p = 0.034), and mean SV during HUT (p < 0.001). We found no significant impact of sex on orthostatic changes of HR and BP. Mean TPR during HUT increased with age (p = 0.001), particularly in older women. Orthostatic changes of HR and diastolic BP, DB ratio, and Valsalva ratio became attenuated with age (p = 0.018, p = 0.006, p < 0.001, and p < 0.001, respectively).

Conclusions

Our study suggests that aging rather than sex needs to be taken into account when interpreting HR and BP changes during prolonged HUT performance.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, Cheshire WP, Chelimsky T, Cortelli P, Gibbons CH, Goldstein DS, Hainsworth R, Hilz MJ, Jacob G, Kaufmann H, Jordan J, Lipsitz LA, Levine BD, Low PA, Mathias C, Raj SR, Robertson D, Sandroni P, Schatz I, Schondorff R, Stewart JM, van Dijk JG (2011) Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 21:69–72PubMedCrossRef Freeman R, Wieling W, Axelrod FB, Benditt DG, Benarroch E, Biaggioni I, Cheshire WP, Chelimsky T, Cortelli P, Gibbons CH, Goldstein DS, Hainsworth R, Hilz MJ, Jacob G, Kaufmann H, Jordan J, Lipsitz LA, Levine BD, Low PA, Mathias C, Raj SR, Robertson D, Sandroni P, Schatz I, Schondorff R, Stewart JM, van Dijk JG (2011) Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 21:69–72PubMedCrossRef
2.
Zurück zum Zitat Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, Deharo JC, Gajek J, Gjesdal K, Krahn A, Massin M, Pepi M, Pezawas T, Ruiz Granell R, Sarasin F, Ungar A, van Dijk JG, Walma EP, Wieling W (2009) Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 30:2631–2671PubMedPubMedCentralCrossRef Moya A, Sutton R, Ammirati F, Blanc JJ, Brignole M, Dahm JB, Deharo JC, Gajek J, Gjesdal K, Krahn A, Massin M, Pepi M, Pezawas T, Ruiz Granell R, Sarasin F, Ungar A, van Dijk JG, Walma EP, Wieling W (2009) Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 30:2631–2671PubMedPubMedCentralCrossRef
3.
Zurück zum Zitat Fitzpatrick AP, Theodorakis G, Vardas P, Sutton R (1991) Methodology of head-up tilt testing in patients with unexplained syncope. J Am Coll Cardiol 17:125–130PubMedCrossRef Fitzpatrick AP, Theodorakis G, Vardas P, Sutton R (1991) Methodology of head-up tilt testing in patients with unexplained syncope. J Am Coll Cardiol 17:125–130PubMedCrossRef
4.
Zurück zum Zitat Gibbons CH, Freeman R (2006) Delayed orthostatic hypotension: a frequent cause of orthostatic intolerance. Neurology 67:28–32PubMedCrossRef Gibbons CH, Freeman R (2006) Delayed orthostatic hypotension: a frequent cause of orthostatic intolerance. Neurology 67:28–32PubMedCrossRef
5.
Zurück zum Zitat Gurevich T, Machmid H, Klepikov D, Ezra A, Giladi N, Peretz C (2014) Head-up tilt testing for detecting orthostatic hypotension: how long do we need to wait? Neuroepidemiology 43:239–243PubMedCrossRef Gurevich T, Machmid H, Klepikov D, Ezra A, Giladi N, Peretz C (2014) Head-up tilt testing for detecting orthostatic hypotension: how long do we need to wait? Neuroepidemiology 43:239–243PubMedCrossRef
6.
Zurück zum Zitat Fortin J, Habenbacher W, Heller A, Hacker A, Grullenberger R, Innerhofer J, Passath H, Wagner C, Haitchi G, Flotzinger D, Pacher R, Wach P (2006) Non-invasive beat-to-beat cardiac output monitoring by an improved method of transthoracic bioimpedance measurement. Comput Biol Med 36:1185–1203PubMedCrossRef Fortin J, Habenbacher W, Heller A, Hacker A, Grullenberger R, Innerhofer J, Passath H, Wagner C, Haitchi G, Flotzinger D, Pacher R, Wach P (2006) Non-invasive beat-to-beat cardiac output monitoring by an improved method of transthoracic bioimpedance measurement. Comput Biol Med 36:1185–1203PubMedCrossRef
7.
Zurück zum Zitat Fortin J, Marte W, Grullenberger R, Hacker A, Habenbacher W, Heller A, Wagner C, Wach P, Skrabal F (2006) Continuous non-invasive blood pressure monitoring using concentrically interlocking control loops. Comput Biol Med 36:941–957PubMedCrossRef Fortin J, Marte W, Grullenberger R, Hacker A, Habenbacher W, Heller A, Wagner C, Wach P, Skrabal F (2006) Continuous non-invasive blood pressure monitoring using concentrically interlocking control loops. Comput Biol Med 36:941–957PubMedCrossRef
8.
Zurück zum Zitat Braune S, Auer A, Schulte-Monting J, Schwerbrock S, Lucking CH (1996) Cardiovascular parameters: sensitivity to detect autonomic dysfunction and influence of age and sex in normal subjects. Clin Auton Res 6:3–15PubMedCrossRef Braune S, Auer A, Schulte-Monting J, Schwerbrock S, Lucking CH (1996) Cardiovascular parameters: sensitivity to detect autonomic dysfunction and influence of age and sex in normal subjects. Clin Auton Res 6:3–15PubMedCrossRef
9.
Zurück zum Zitat Laitinen T, Niskanen L, Geelen G, Lansimies E, Hartikainen J (2004) Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects. J Appl physiol (Bethesda, Md: 1985) 96:2333–2340CrossRef Laitinen T, Niskanen L, Geelen G, Lansimies E, Hartikainen J (2004) Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects. J Appl physiol (Bethesda, Md: 1985) 96:2333–2340CrossRef
10.
Zurück zum Zitat Low PA, Denq JC, Opfer-Gehrking TL, Dyck PJ, O’Brien PC, Slezak JM (1997) Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects. Muscle Nerve 20:1561–1568PubMedCrossRef Low PA, Denq JC, Opfer-Gehrking TL, Dyck PJ, O’Brien PC, Slezak JM (1997) Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects. Muscle Nerve 20:1561–1568PubMedCrossRef
11.
Zurück zum Zitat Mellingsaeter MR, Wyller VB, Wyller TB, Ranhoff AH (2013) Gender differences in orthostatic tolerance in the elderly. Aging Clin Exp Res 25:659–665PubMedCrossRef Mellingsaeter MR, Wyller VB, Wyller TB, Ranhoff AH (2013) Gender differences in orthostatic tolerance in the elderly. Aging Clin Exp Res 25:659–665PubMedCrossRef
12.
Zurück zum Zitat Narkiewicz K, Phillips BG, Kato M, Hering D, Bieniaszewski L, Somers VK (2005) Gender-selective interaction between aging, blood pressure, and sympathetic nerve activity. Hypertension 45:522–525PubMedCrossRef Narkiewicz K, Phillips BG, Kato M, Hering D, Bieniaszewski L, Somers VK (2005) Gender-selective interaction between aging, blood pressure, and sympathetic nerve activity. Hypertension 45:522–525PubMedCrossRef
13.
Zurück zum Zitat Petersen ME, Williams TR, Gordon C, Chamberlain-Webber R, Sutton R (2000) The normal response to prolonged passive head up tilt testing. Heart (British Cardiac Society) 84:509–514CrossRef Petersen ME, Williams TR, Gordon C, Chamberlain-Webber R, Sutton R (2000) The normal response to prolonged passive head up tilt testing. Heart (British Cardiac Society) 84:509–514CrossRef
14.
Zurück zum Zitat Tahvanainen A, Leskinen M, Koskela J, Ilveskoski E, Nordhausen K, Oja H, Kahonen M, Koobi T, Mustonen J, Porsti I (2009) Ageing and cardiovascular responses to head-up tilt in healthy subjects. Atherosclerosis 207:445–451PubMedCrossRef Tahvanainen A, Leskinen M, Koskela J, Ilveskoski E, Nordhausen K, Oja H, Kahonen M, Koobi T, Mustonen J, Porsti I (2009) Ageing and cardiovascular responses to head-up tilt in healthy subjects. Atherosclerosis 207:445–451PubMedCrossRef
15.
Zurück zum Zitat Freeman R (2006) Assessment of cardiovascular autonomic function. Clin Neurophysiol 117:716–730PubMedCrossRef Freeman R (2006) Assessment of cardiovascular autonomic function. Clin Neurophysiol 117:716–730PubMedCrossRef
16.
Zurück zum Zitat Mathias CJ, Low DA, Iodice V, Bannister R (2013) Investigation of autonomic disorders. In: Mathias CJ, Bannister R (eds) Autonomic failure. A textbook of clinical disorders of the autonomic nervous system. University Press, Oxford, pp 259–289CrossRef Mathias CJ, Low DA, Iodice V, Bannister R (2013) Investigation of autonomic disorders. In: Mathias CJ, Bannister R (eds) Autonomic failure. A textbook of clinical disorders of the autonomic nervous system. University Press, Oxford, pp 259–289CrossRef
17.
Zurück zum Zitat Zeger SL, Liang KY (1986) Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42:121–130PubMedCrossRef Zeger SL, Liang KY (1986) Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42:121–130PubMedCrossRef
18.
Zurück zum Zitat Barnett SR, Morin RJ, Kiely DK, Gagnon M, Azhar G, Knight EL, Nelson JC, Lipsitz LA (1999) Effects of age and gender on autonomic control of blood pressure dynamics. Hypertension 33:1195–1200PubMedCrossRef Barnett SR, Morin RJ, Kiely DK, Gagnon M, Azhar G, Knight EL, Nelson JC, Lipsitz LA (1999) Effects of age and gender on autonomic control of blood pressure dynamics. Hypertension 33:1195–1200PubMedCrossRef
19.
Zurück zum Zitat Kneale BJ, Chowienczyk PJ, Brett SE, Coltart DJ, Ritter JM (2000) Gender differences in sensitivity to adrenergic agonists of forearm resistance vasculature. J Am Coll Cardiol 36:1233–1238PubMedCrossRef Kneale BJ, Chowienczyk PJ, Brett SE, Coltart DJ, Ritter JM (2000) Gender differences in sensitivity to adrenergic agonists of forearm resistance vasculature. J Am Coll Cardiol 36:1233–1238PubMedCrossRef
20.
Zurück zum Zitat Charkoudian N, Joyner MJ, Johnson CP, Eisenach JH, Dietz NM, Wallin BG (2005) Balance between cardiac output and sympathetic nerve activity in resting humans: role in arterial pressure regulation. J Physiol 568:315–321PubMedPubMedCentralCrossRef Charkoudian N, Joyner MJ, Johnson CP, Eisenach JH, Dietz NM, Wallin BG (2005) Balance between cardiac output and sympathetic nerve activity in resting humans: role in arterial pressure regulation. J Physiol 568:315–321PubMedPubMedCentralCrossRef
21.
Zurück zum Zitat Hart EC, Charkoudian N, Wallin BG, Curry TB, Eisenach JH, Joyner MJ (2009) Sex differences in sympathetic neural-hemodynamic balance: implications for human blood pressure regulation. Hypertension 53:571–576PubMedPubMedCentralCrossRef Hart EC, Charkoudian N, Wallin BG, Curry TB, Eisenach JH, Joyner MJ (2009) Sex differences in sympathetic neural-hemodynamic balance: implications for human blood pressure regulation. Hypertension 53:571–576PubMedPubMedCentralCrossRef
22.
Zurück zum Zitat London GM, Guerin AP, Pannier B, Marchais SJ, Stimpel M (1995) Influence of sex on arterial hemodynamics and blood pressure. Role of body height. Hypertension 26:514–519PubMedCrossRef London GM, Guerin AP, Pannier B, Marchais SJ, Stimpel M (1995) Influence of sex on arterial hemodynamics and blood pressure. Role of body height. Hypertension 26:514–519PubMedCrossRef
23.
Zurück zum Zitat Jones PP, Shapiro LF, Keisling GA, Jordan J, Shannon JR, Quaife RA, Seals DR (2001) Altered autonomic support of arterial blood pressure with age in healthy men. Circulation 104:2424–2429PubMedCrossRef Jones PP, Shapiro LF, Keisling GA, Jordan J, Shannon JR, Quaife RA, Seals DR (2001) Altered autonomic support of arterial blood pressure with age in healthy men. Circulation 104:2424–2429PubMedCrossRef
24.
Zurück zum Zitat Brodde OE, Leineweber K (2004) Autonomic receptor systems in the failing and aging human heart: similarities and differences. Eur J Pharmacol 500:167–176PubMedCrossRef Brodde OE, Leineweber K (2004) Autonomic receptor systems in the failing and aging human heart: similarities and differences. Eur J Pharmacol 500:167–176PubMedCrossRef
25.
Zurück zum Zitat Smulyan H, Asmar RG, Rudnicki A, London GM, Safar ME (2001) Comparative effects of aging in men and women on the properties of the arterial tree. J Am Coll Cardiol 37:1374–1380PubMedCrossRef Smulyan H, Asmar RG, Rudnicki A, London GM, Safar ME (2001) Comparative effects of aging in men and women on the properties of the arterial tree. J Am Coll Cardiol 37:1374–1380PubMedCrossRef
26.
Zurück zum Zitat Barnes JN, Hart EC, Curry TB, Nicholson WT, Eisenach JH, Wallin BG, Charkoudian N, Joyner MJ (2014) Aging enhances autonomic support of blood pressure in women. Hypertension 63:303–308PubMedPubMedCentralCrossRef Barnes JN, Hart EC, Curry TB, Nicholson WT, Eisenach JH, Wallin BG, Charkoudian N, Joyner MJ (2014) Aging enhances autonomic support of blood pressure in women. Hypertension 63:303–308PubMedPubMedCentralCrossRef
27.
Zurück zum Zitat Redfield MM, Jacobsen SJ, Borlaug BA, Rodeheffer RJ, Kass DA (2005) Age- and gender-related ventricular-vascular stiffening: a community-based study. Circulation 112:2254–2262PubMedCrossRef Redfield MM, Jacobsen SJ, Borlaug BA, Rodeheffer RJ, Kass DA (2005) Age- and gender-related ventricular-vascular stiffening: a community-based study. Circulation 112:2254–2262PubMedCrossRef
28.
Zurück zum Zitat Baldi JC, Lalande S, Carrick-Ranson G, Johnson BD (2007) Postural differences in hemodynamics and diastolic function in healthy older men. Eur J Appl Physiol 99:651–657PubMedCrossRef Baldi JC, Lalande S, Carrick-Ranson G, Johnson BD (2007) Postural differences in hemodynamics and diastolic function in healthy older men. Eur J Appl Physiol 99:651–657PubMedCrossRef
29.
Zurück zum Zitat Wieling W, Krediet CT, van Dijk N, Linzer M, Tschakovsky ME (2007) Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (London, England: 1979) 112:157–165CrossRef Wieling W, Krediet CT, van Dijk N, Linzer M, Tschakovsky ME (2007) Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (London, England: 1979) 112:157–165CrossRef
30.
Metadaten
Titel
Sex and age effects on cardiovascular autonomic function in healthy adults
verfasst von
Jean-Pierre Ndayisaba
Alessandra Fanciulli
Roberta Granata
Susanne Duerr
Florian Hintringer
Georg Goebel
Florian Krismer
Gregor K. Wenning
Publikationsdatum
01.10.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 5/2015
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-015-0310-1

Weitere Artikel der Ausgabe 5/2015

Clinical Autonomic Research 5/2015 Zur Ausgabe

Neu in den Fachgebieten Neurologie und Psychiatrie

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.