title: Arterial Pressure, Heart Rate, and Cerebral Hemodynamics Across the Adult Life Span.
abstract: Age-related alterations in systemic and cerebral hemodynamics are not well understood. The purpose of this study is to characterize age-related alterations in beat-to-beat oscillations in arterial blood pressure (BP), heart rate (HR), cerebral blood flow (CBF), cardiac baroreflex sensitivity, and dynamic cerebral autoregulation across the adult life span. We studied 136 healthy adults aged 21 to 80 years (60% women). Beat-to-beat BP, HR, and CBF velocity were measured at rest and during sit-stand maneuvers to mimic effects of postural changes on BP and CBF. Transfer function analysis was used to assess baroreflex sensitivity and dynamic cerebral autoregulation. Carotid-femoral pulse wave velocity was measured to assess central arterial stiffness. Advanced aging was associated with elevated carotid-femoral pulse wave velocity, systolic and pulse BP, cerebrovascular resistance, and CBF pulsatility, but reduced mean CBF velocity. Compared with the young and middle-aged, older adults had lower beat-to-beat BP, HR, and CBF variability in the low-frequency ranges at rest, but higher BP and CBF variability during sit-stand maneuvers. Baroreflex sensitivity was reduced, whereas dynamic cerebral autoregulation gain was elevated at rest in older adults. Multiple linear regression analysis indicated that systolic BP variability is correlated positively with carotid-femoral pulse wave velocity independent of HR variability. In conclusion, advanced aging is associated with elevated pulsatility in BP and CBF; reduced beat-to-beat low-frequency oscillations in BP, HR, and CBF; and impaired baroreflex sensitivity and dynamic cerebral autoregulation at rest. The augmented BP and CBF variability in older adults during sit-stand maneuvers indicate diminished cardiovascular regulatory capability and increased hemodynamic stress on the cerebral circulation with aging.
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Chang-Yang
authors.initials: CY
authors.lastname: Xing
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Takashi
authors.initials: T
authors.lastname: Tarumi
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Rutger L
authors.initials: RL
authors.lastname: Meijers
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Marcel
authors.initials: M
authors.lastname: Turner
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Justin
authors.initials: J
authors.lastname: Repshas
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Li
authors.initials: L
authors.lastname: Xiong
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Kan
authors.initials: K
authors.lastname: Ding
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Wanpen
authors.initials: W
authors.lastname: Vongpatanasin
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.).
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Yuan
authors.affiliation: From the Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas (C.-Y.X., T.T., R.L.M., M.T., J.R., R.Z.); Department of Internal Medicine (C.-Y.X., W.V., R.Z.) and Department of Neurology and Neurotherapeutics (T.T., K.D., R.Z.), University of Texas Southwestern Medical Center, Dallas; Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China (C.-Y.X., L.-J.Y.); Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, The Netherlands (R.L.M.); and Department of Medicine and Therapeutics, Chinese University of Hong Kong, China (L.X.). rongzhang@texashealth.org.
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D062186:Arterial Pressure / Q000502:physiology*; D017704:Baroreflex / Q000502:physiology; D001783:Blood Flow Velocity / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology*; D004562:Electrocardiography; D005260:Female; D064368:Healthy Volunteers; D006339:Heart Rate / Q000502:physiology*; D006706:Homeostasis; D006801:Humans; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D017585:Ultrasonography, Doppler, Transcranial; D059289:Vascular Stiffness / Q000502:physiology; D055815:Young Adult
keywords: aging; blood pressure; cerebrovascular circulation; heart rate; hemodynamics