Cardiovascular Response to Graded Lower Body Negative Pressure in Young and Elderly Man

Lower body negative pressure (LBNP) reduces central venous pressure (CVP) and cardiac output. The elderly are reported to have a limited capacity to increase cardiac output by increasing heart rate (HR), are especially dependent on end diastolic volume to maintain stroke volume and therefore should be especially vulnerable to LBNP. The present study compared the effects of LBNP in the young and old. Stroke volume was assessed non‐invasively as stroke distance (SD) by aortovelography. Two groups of healthy male volunteers were studied: eight young (29.7 ± 2.0 years, mean ± S.E.M.) and nine old (70.1 ± 0.9 years). LBNP was applied progressively at 17.5, 35 and 50 mmHg in 20 min steps, with measurements taken during each steady state. There were similar, significant, falls in CVP in both groups. SD fell significantly in both groups from respective control values of 24.8 ± 1.6 and 16.6 ± 0.9 cm to 12.5 ± 1.3 and 8.9 ± 0.4 cm at a LBNP of 50 mmHg. Although SD in the elderly was significantly lower than in the young, the LBNP‐induced changes were not different between groups. Both groups produced similar significant increases in vascular resistance, HR, plasma vasopressin (AVP) and noradrenaline. Mean arterial blood pressure (MBP) and plasma adrenaline did not change significantly. Therefore healthy old men respond to LBNP in a similar manner to the young, although MBP and SD are regulated around different baselines in the two groups.

[1]  R. J. Whitney,et al.  The measurement of volume changes in human limbs , 1953, The Journal of physiology.

[2]  L L Huntsman,et al.  Noninvasive Doppler Determination of Cardiac Output in Man: Clinical Validation , 1983, Circulation.

[3]  H. Gavras,et al.  Effect of Aging on Vasopressin, Catecholamines, and Alpha2‐Adrenergic Receptors , 1990, Journal of the American Geriatrics Society.

[4]  P. Smits,et al.  Attenuated Forearm Vasodilator Response to Atrial Natriuretic Factor in the Elderly , 1991, Hypertension.

[5]  G. W. Hoffler,et al.  Association of sex and age with responses to lower-body negative pressure. , 1988, Journal of applied physiology.

[6]  J. T. Santinga,et al.  Comparison of differences in the hemodynamic response to passive postural stress in healthy subjects >70 years and <30 years of age , 1991 .

[7]  J. Weir,et al.  Effect of age and blood pressure on aortic size and stroke distance. , 1986, British heart journal.

[8]  Rawles Jm Stroke distance--an improved measure of cardiovascular function. , 1989 .

[9]  F. Tristani,et al.  Effect of age and coronary heart disease on the circulatory responses to graded lower body negative pressure. , 1982, Cardiovascular research.

[10]  J. Rowe,et al.  The response of arginine vasopressin to intravenous ethanol and hypertonic saline in man: the impact of aging. , 1978, Journal of gerontology.

[11]  K. Tanaka,et al.  Echocardiographic measurement of aortic root diameter. , 1976, Japanese heart journal.

[12]  K. Minaker,et al.  Age-related failure of volume-pressure-mediated vasopressin release. , 1982, The Journal of clinical endocrinology and metabolism.

[13]  E. Lakatta,et al.  Diminished Inotropic Response of Aged Myocardium to Catecholamines , 1975, Circulation research.

[14]  B. Folkow,et al.  Age- and pressure-dependent changes of systemic resistance vessels concerning the relationships between geometric design, wall distensibility, vascular reactivity and smooth muscle sensitivity. , 1984, Acta physiologica Scandinavica.

[15]  D. Gibson Stroke distance--an improved measure of cardiovascular function? , 1985, British heart journal.

[16]  R. Hainsworth,et al.  The effects of lower body negative pressure on baroreceptor responses in humans , 1990, Experimental physiology.

[17]  D. Trunkey,et al.  Preventable trauma deaths. A review of trauma care systems development. , 1985, JAMA.

[18]  F. Abboud,et al.  Increase in sympathetic activity with age. II. Role of impairment of cardiopulmonary baroreflexes. , 1991, The American journal of physiology.

[19]  N. Haites,et al.  Aortic blood velocity measurement in healthy adults using a simple ultrasound technique. , 1983, Cardiovascular research.

[20]  E. Kirkman,et al.  Attenuation of the acute cardiovascular responses to haemorrhage by tissue injury in the conscious rat. , 1989, Quarterly journal of experimental physiology.

[21]  E. Faragher,et al.  Cardiovascular haemodynamics and the response of vasopressin, aldosterone, plasma renin activity and plasma catecholamines to head-up tilt in young and old healthy subjects. , 1986, Age and ageing.

[22]  M. Horan,et al.  Cortisol production rate and the urinary excretion of 17-hydroxycorticosteroids, free cortisol, and 6 beta-hydroxycortisol in healthy elderly men and women. , 1993, Journal of gerontology.

[23]  M. Horan,et al.  Use of stroke distance in the early detection of simulated blood loss. , 1998, The Journal of trauma.

[24]  R S Mackay,et al.  Non-invasive cardiac output measurement. , 1972, Microvascular research.

[25]  J. Ward,et al.  Modification by lung inflation of the vascular responses from the carotid body chemoreceptors and other receptors in dogs. , 1986, The Journal of physiology.

[26]  T Länne,et al.  Cardiovascular response to acute hypovolemia in relation to age. Implications for orthostasis and hemorrhage. , 2000, American journal of physiology. Heart and circulatory physiology.

[27]  A. Nicogossian,et al.  Physiological effects of locally applied reduced pressure in man. , 1974, Physiological reviews.

[28]  X. Shi,et al.  Arterial and cardiopulmonary baroreflexes in 60- to 69- vs. 18- to 36-yr-old humans. , 1996, Journal of applied physiology.

[29]  J. J. Smith,et al.  Effects of aging on baroreflex regulation of sympathetic activity in humans. , 1992, The American journal of physiology.

[30]  F. T. de Dombal,et al.  Retrospective study of 1000 deaths from injury in England and Wales , 1988, British medical journal.

[31]  E. Lakatta,et al.  Age-associated decrease in heart rate response to isoproterenol in dogs , 1979, Mechanisms of Ageing and Development.

[32]  H. Müller-Hermelink,et al.  Admission criteria for immunogerontological studies in man: The senieur protocol , 1984, Mechanisms of Ageing and Development.

[33]  D. Knook,et al.  Necessity of the assessment of health status in human immunogerontological studies: Evaluation of the senieur protocol , 1990, Mechanisms of Ageing and Development.

[34]  N. Shock,et al.  Changes in Cardiac Output with Age , 1955, Circulation.

[35]  I. Davies,et al.  Age-associated alterations in thirst and arginine vasopressin in response to a water or sodium load. , 1995, Age and ageing.

[36]  K. Frayn,et al.  Use of alumina columns to prepare plasma samples for liquid-chromatographic determination of catecholamines. , 1987, Clinical chemistry.

[37]  C. Faull,et al.  Water balance in elderly people: is there a deficiency of vasopressin? , 1993, Age and ageing.

[38]  S. Goldberg,et al.  Number of cardiac cycles required to accurately determine mean velocity of blood flow in the ascending aorta and pulmonary trunk. , 1987, The American journal of cardiology.

[39]  N. Secher,et al.  Bradycardia during severe but reversible hypovolemic shock in man. , 1984, Circulatory shock.

[40]  S. Lightman,et al.  Sexual dimorphism in the posterior pituitary response to stress in the rat. , 1985, Endocrinology.

[41]  W. Segar,et al.  The regulation of antidiuretic hormone release in man: I. Effects of change in position and ambient temperature on blood ADH levels. , 1968, The Journal of clinical investigation.

[42]  C. Johnston,et al.  Effects of drinking on thirst and vasopressin in dehydrated elderly men. , 1993, The American journal of physiology.

[43]  D. B. Friedman,et al.  BRADYCARDIA DURING REVERSIBLE HYPOVOLAEMIC SHOCK: ASSOCIATED NEURAL REFLEX MECHANISMS AND CLINICAL IMPLICATIONS , 1992, Clinical and experimental pharmacology & physiology.

[44]  B. Robinson,et al.  Is orthostatic hypotension in the elderly due to autonomic failure? , 1990, Age and ageing.

[45]  M. Herr,et al.  Head-down-tilt bed rest alters forearm vasodilator and vasoconstrictor responses. , 1998, Journal of applied physiology.

[46]  S. Lundin,et al.  Effects of ageing on cardiac performance and coronary flow in spontaneously hypertensive and normotensive rats. , 1985, Acta physiologica Scandinavica.

[47]  J. Taylor,et al.  Sympathoadrenal-circulatory regulation of arterial pressure during orthostatic stress in young and older men. , 1992, The American journal of physiology.