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Gender differences in orthostatic tolerance in the elderly

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Abstract

Background

Gender differences in orthostatic tolerance in the elderly are poorly studied and understood.

Methods

48 healthy elderly over 65 years (24 women), free from medication and without chronic diseases, were subjected to head-up tilt (HUT) tests: 30° for 10 min and 70° for 40 min. Blood pressures, stroke volume, total peripheral resistance, blood pressure variability, heart rate variability and baroreceptor sensitivity were measured and test terminations due to vasovagal syncope or unbearable presyncopal symptoms were registered.

Results

Mean age was 72; women and men differed in body mass index; 22.2 versus 24.8, respectively (p < 0.01). Mean blood pressures were lower among women, with 88 and 98 mmHg, respectively (p < 0.01) (rest) and 86 and 96 mmHg (p < 0.01) (tilt 30°). Mean total peripheral resistance index was significantly higher among women during 70° tilt, 13.5 versus 10.8 (p < 0.01); no gender differences in heart rate were seen. Women had lower LF/HF ratio (an index of sympathovagal balance) at rest and during 30° tilt (both p < 0.05); other heart rate variability measures and baroreceptor sensitivity did not differ. Two women, 9 %, and 8 men, 33 %, terminated head-up tilt test due to vasovagal syncope or presyncopal symptoms. Gender difference was marginally significant (p = 0.05, log-rank test). Higher heart rate at rest (p < 0.01) was the only variable significantly associated with the risk of syncope.

Conclusions

Our results indicate that elderly men have poorer orthostatic tolerance during protracted postural stress than women of the same age. The underlying reason might be differences in vascular rather than cardiac autonomic control.

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Acknowledgments

This work was supported by Oslo University Hospital

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway

    Marte Rognstad Mellingsæter & Torgeir Bruun Wyller

  2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Marte Rognstad Mellingsæter, Vegard Bruun Wyller & Torgeir Bruun Wyller

  3. Department of Paediatrics, Akershus University Hospital, Nordbyhagen, Norway

    Vegard Bruun Wyller

  4. Department of Clinical Science, University of Bergen, Bergen, Norway

    Anette Hylen Ranhoff

  5. Diakonhjemmet Hospital, Oslo, Norway

    Anette Hylen Ranhoff

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  1. Marte Rognstad Mellingsæter
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  2. Vegard Bruun Wyller
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Correspondence to Marte Rognstad Mellingsæter.

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Mellingsæter, M.R., Wyller, V.B., Wyller, T.B. et al. Gender differences in orthostatic tolerance in the elderly. Aging Clin Exp Res 25, 659–665 (2013). https://doi.org/10.1007/s40520-013-0092-z

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  • DOI: https://doi.org/10.1007/s40520-013-0092-z

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