title: Ageing and water homeostasis.
abstract: This review outlines current knowledge concerning fluid intake and volume homeostasis in ageing. The physiology of vasopressin is summarized. Studies have been carried out to determine orthostatic changes in plasma volume and to assess the effect of water ingestion in normal subjects, elderly subjects, and patients with dysautonomias. About 14% of plasma volume shifts out of the vasculature within 30 minutes of upright posture. Oral ingestion of water raises blood pressure in individuals with impaired autonomic reflexes and is an important source of noise in blood pressure trials in the elderly. On the average, oral ingestion of 16 ounces (473ml) of water raises blood pressure 11 mmHg in elderly normal subjects. In patients with autonomic impairment, such as multiple system atrophy, strikingly exaggerated pressor effects of water have been seen with blood pressure elevations greater than 75 mmHg not at all uncommon. Ingestion of water is a major determinant of blood pressure in the elderly population. Volume homeostasis is importantly affected by posture and large changes in plasma volume may occur within 30 minutes when upright posture is assumed.
authors.affiliation: Autonomic Dysfunction Center, Department of Medicine, Vanderbilt University, Nashville TN 37232 2195, USA.
authors.forename: David
authors.initials: D
authors.lastname: Robertson
authors.forename: Jens
authors.initials: J
authors.lastname: Jordan
authors.forename: Giris
authors.initials: G
authors.lastname: Jacob
authors.forename: Terry
authors.initials: T
authors.lastname: Ketch
authors.forename: John R
authors.initials: JR
authors.lastname: Shannon
authors.forename: Italo
authors.initials: I
authors.lastname: Biaggioni
mesh_terms: D000375:Aging / Q000378:metabolism*; D006706:Homeostasis; D006801:Humans; D014667:Vasopressins / Q000378:metabolism*; D014867:Water / Q000378:metabolism*
chemical_list: D014867:Water; D014667:Vasopressins