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

01-10-2015 | Research Article

Sex and age effects on cardiovascular autonomic function in healthy adults

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

Published in: Clinical Autonomic Research | Issue 5/2015

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
16.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
go back to reference 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.
Metadata
Title
Sex and age effects on cardiovascular autonomic function in healthy adults
Authors
Jean-Pierre Ndayisaba
Alessandra Fanciulli
Roberta Granata
Susanne Duerr
Florian Hintringer
Georg Goebel
Florian Krismer
Gregor K. Wenning
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research / Issue 5/2015
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-015-0310-1

Other articles of this Issue 5/2015

Clinical Autonomic Research 5/2015 Go to the issue