Baroreflex function in elderly hypertensives.

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Abstract
Baroreflex function was assessed in elderly hypertensive patients and compared with that observed in young hypertensives and young normotensives. Mean arterial pressure was reduced by 20% using i.v. nitroprusside infusion in 10 elderly hypertensive patients (older than 65 yr and diastolic pressures over 95 mm Hg), in 10 young hypertensive (under 60 yr and diastolic pressures over 95 mm Hg), and in 7 young normotensive subjects (under 60 yr and diastolic pressures under 95 mm Hg). Elderly subjects demonstrated greater sensitivity (P < 0.005) and greater variability of response (P < 0.025) to nitroprusside than either young group. There was no significant difference between the slight heart rate increases observed in the supine position in the 3 groups. However, in the erect position, heart rate increases were significantly less in the elderly hypertensive group than in the young hypertensive group (P < 0.01) or the young normotensive group (P < 0.005). Furthermore, the slope of the regression line relating change in blood pressure with change in R-R interval was less for the elderly patients than for the young hypertensives (P < 0.05) or the young normotensives (P < 0.025). Evidently, the heart rate component of the baroreflex is impaired in elderly hypertensives, and anticipate that the clinical response to antihypertensive drugs will be altered.