Anna Hofsten

Age-related differences in blood pressure and heart rate responses to changes in body position : Results from a study with serial measurements in the supine and standing positions in 30-, 50- and 60-year-old men

This population-based study presents the blood pressure and heart rate responses to sudden changes in body position in representative groups of men aged 30 (n = 50), 50 (n = 44) and 60 (n = 69) years, using an unbiased method for non-invasive blood pressure measurements. Blood pressure and heart rate were measured every minute during three 7-min periods in the supine, standing and again supine positions. Whereas there was an initial decrease in systolic blood pressure upon standing in men aged 50 and 60 years, an increase was seen in the 30-year-olds. The diastolic blood pressure increased in all age groups, but less in the older compared to the younger men. In all age groups, the changes in systolic blood pressure upon standing were transient, while the changes in the diastolic blood pressure lasted during the entire observation period. The heart rate increased to a similar extent upon standing in all age groups. No symptomatic hypotension was observed. After resuming the supine position, both blood pressure and heart rate returned towards the levels initially recorded. This population-based study confirms previous observations in selected subjects of age-related attenuation in blood pressure response to change in body position. The study also shows that blood pressure and heart rate are rapidly stabilized upon standing up.

Does Hypertension or a Previous Myocardial Infarction Influence the Blood Pressure and Heart Rate Responses to Changes in Body Position? Results from a Study with Serial Measurements in the Supine and Standing Positions in 60-year-old Men

An age-related attenuation of the normal increase in diastolic blood pressure and heart rate upon standing has previously been observed in man. Whether this is due to ageing as such, or a consequence of a higher prevalence of cardiovascular disease in older compared to younger subjects, is unclear. This populationbased study was conducted to address this question. It was carried out in three groups of 60-year-old men: (i) with hypertension (n = 75), (ii) with a previous myocardial infarction (n = 39), and (iii) without any of these diseases, thus constituting a control group (n = 41). Blood pressure and heart rate were assessed during three 7-min periods (supine-standing-supine), using an unbiased non-invasive method. The cardiovascular responses were both qualitatively and quantitatively similar in all three groups, i.e. the increases in diastolic blood pressure and heart rate upon standing, and decreases upon laying down, were of a similar magnitude. In conclusion, 60-year-old men with hypertension or a previous myocardial infarction had blood pressure and heart rate responses similar to those of men of the same age who did not have these diseases. This indicates that the attenuated response previously reported in older compared to younger people is not explained by the higher prevalence of these cardiovascular diseases in the elderly, but is merely an age-dependent characteristic.An age-related attenuation of the normal increase in diastolic blood pressure and heart rate upon standing has previously been observed in man. Whether this is due to ageing as such, or a consequence of a higher prevalence of cardiovascular disease in older compared to younger subjects, is unclear. This population-based study was conducted to address this question. It was carried out in three groups of 60-year-old men: (i) with hypertension (n = 75), (ii) with a previous myocardial infarction (n = 39), and (iii) without any of these diseases, thus constituting a control group (n = 41). Blood pressure and heart rate were assessed during three 7-min periods (supine-standing-supine), using an unbiased non-invasive method. The cardiovascular responses were both qualitatively and quantitatively similar in all three groups, i.e. the increases in diastolic blood pressure and heart rate upon standing, and decreases upon laying down, were of a similar magnitude. In conclusion, 60-year-old men with hypertension or a previous myocardial infarction had blood pressure and heart rate responses similar to those of men of the same age who did not have these diseases. This indicates that the attenuated response previously reported in older compared to younger people is not explained by the higher prevalence of these cardiovascular diseases in the elderly, but is merely an age-dependent characteristic.