Sex and age effects on cardiovascular autonomic function in healthy adults.
OBJECTIVE
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.
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria. jean-pierre.ndayisaba@i-med.ac.at.|Division of Neurobiology, Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. jean-pierre.ndayisaba@i-med.ac.at.
Jean-Pierre
JP
Ndayisaba
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.|Department of Neuroscience, Mental Health and Sensory Organs, "Sapienza" University of Rome, Rome, Italy.
Alessandra
A
Fanciulli
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Roberta
R
Granata
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Susanne
S
Duerr
Department of Cardiology, Medical University of Innsbruck, Innsbruck, Austria.
Florian
F
Hintringer
Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria.
Georg
G
Goebel
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Florian
F
Krismer
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria. gregor.wenning@i-med.ac.at.|Division of Neurobiology, Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. gregor.wenning@i-med.ac.at.
Gregor K
GK
Wenning
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D001341:Autonomic Nervous System / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D012727:Sex Characteristics; D018667:Tilt-Table Test / Q000379:methods*; D014636:Valsalva Maneuver / Q000502:physiology; D055815:Young Adult
Cardiovascular autonomic function; Deep breathing; Head-up tilting; Sex and age effects; Valsalva maneuver