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Am J Physiol Regul Integr Comp Physiol (August 1, 2002). doi:10.1152/ajpregu.00298.2002
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Articles in PresS, published online ahead of print August 1, 2002
Am J Physiol Regu Physiol, 10.1152/ajpregu.00298.2002
Submitted on May 28, 2002
Accepted on July 25, 2002

The vestibulosympathetic reflex during orthostatic challenge in aging humans

Kevin D Monahan1 and Chester A Ray1*

1 Departments of Medicine (Cardiology) and Cellular and Molecular Physiology, Pennsylvania State University College of Medicine, Hershey, PA, USA

* To whom correspondence should be addressed. E-mail: caray{at}psu.edu.

Aging attenuates the increase in muscle sympathetic nerve activity (MSNA) and elicits hypotension during otolith organ engagement in humans. The purpose of the present study was to determine the neural and cardiovascular responses to otolithic engagement during orthostatic stress in older adults. We hypothesized that age-related impairments in the vestibulosympathetic reflex would persist during orthostatic challenge in older subjects and might compromise arterial blood pressure regulation. MSNA, arterial blood pressure, and heart rate responses to head-down rotation (HDR) performed with and without lower body negative pressure (LBNP) in prone subjects were measured. Ten young (27±1 yr) and 11 older subjects (64±1 yr) were studied prospectively. HDR performed alone elicited an attenuated increase in MSNA in older subjects ({Delta}106±28% vs. {Delta}20±7% for young and older subjects). HDR performed during simultaneous orthostatic stress increased total MSNA further in young ({Delta}53±15%; P<0.05), but not older subjects ({Delta}-5±4%). Older subjects demonstrated consistent significant hypotension during HDR performed both alone ({Delta}-6±2 mmHg) and during LBNP ({Delta}-7±2 mmHg). These data provide experimental support for the concept that age-related impairments in the vestibulosympathetic reflex persist during orthostatic challenge in older adults. Furthermore, these findings are consistent with the concept that age-related alterations in vestibular function might contribute to altered orthostatic blood pressure regulation with age in humans.




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