ABSTRACT
Older adults exhibit augmented renal vasoconstriction during orthostatic stress compared to young adults. Consumption of omega-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fish oil (FO), modulates autonomic nerve activity. However, the effect of omega-3 polyunsaturated fatty acid consumption on the renal vasoconstrictor response to orthostatic stress in young and older adults is unknown. Therefore, 10 young (25 ± 1 years; mean ± SEM) and 10 older (66 ± 2 years) healthy adults ingested 4 g FO daily for 12 weeks, and underwent graded lower body negative pressure (LBNP; -15 and -30 mmHg) pre- and post-FO supplementation. Renal blood flow velocity (RBFV; Doppler ultrasound), arterial blood pressure (BP; photoplethysmographic finger cuff), and heart rate (electrocardiogram) were recorded. Renal vascular resistance (RVR), an index of renal vasoconstriction, was calculated as mean BP/RBFV. All baseline cardiovascular values were similar between groups and visits, except diastolic BP was higher in the older group (P < 0.05). FO supplementation increased erythrocyte EPA and DHA content in both groups (P < 0.05). FO did not affect RVR or RBFV responses to LBNP in either group, but attenuated the mean BP response to LBNP in the older group (older -30 mmHg: pre-FO -4 ± 1 vs. post-FO 0 ± 1 mmHg, P < 0.05; young -30 mmHg: pre-FO -5 ± 1 vs. post-FO -5 ± 2 mmHg). In conclusion, FO supplementation attenuates the mean BP response but does not affect the renal vasoconstrictor response to orthostatic stress in older adults.
Subject(s)
Autonomic Nervous System/drug effects , Blood Pressure/drug effects , Fatty Acids, Omega-3/administration & dosage , Renal Circulation/drug effects , Vasoconstriction/drug effects , Adult , Aged , Dietary Supplements , Female , Humans , Kidney/blood supply , Kidney/diagnostic imaging , Kidney/drug effects , Male , Middle Aged , Young AdultABSTRACT
Aging is associated with alterations of autonomic nerve activity, and dietary intake of omega-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fish oil (FO), can modulate autonomic nerve activity. However, the effect of omega-3 polyunsaturated fatty acid consumption on age-related cardiovascular responses at the onset of isometric handgrip exercise, a time of rapid autonomic adjustments, is unknown. Accordingly, 14 young (25 ± 1 years; mean ± SE) and 15 older (64 ± 2 years) healthy subjects ingested 4 g FO daily for 12 weeks. On pre- and postintervention visits, participants performed 15-sec bouts of isometric handgrip at 10%, 30%, 50%, and 70% maximal voluntary contraction (MVC) while beat-to-beat systolic, diastolic, and mean arterial blood pressure (SBP, DBP, MAP; Finometer) and heart rate (HR; electrocardiogram) were recorded. All baseline cardiovascular variables were similar between groups and visits, except DBP was higher in older subjects (P < 0.05). FO increased erythrocyte EPA and DHA content in both groups (P < 0.05). FO attenuated MAP and DBP increases in response to handgrip in both age groups (change from baseline during 70% MVC handgrip pre- and post-FO: young MAPΔ 14 ± 2 mmHg versus 10 ± 2 mmHg, older MAPΔ 14 ± 3 mmHg versus 11 ± 2 mmHg; young DBPΔ 12 ± 1 mmHg versus 7 ± 2 mmHg, older DBPΔ 12 ± 1 mmHg versus 7 ± 1 mmHg; P < 0.05). FO augmented the PP (SBP-DBP) increase with 70% MVC handgrip in both groups (P < 0.05), but did not alter SBP or HR increases with handgrip. These findings suggest that FO supplementation attenuates MAP and DBP increases at the onset of isometric handgrip exercise in healthy young and older humans.
Subject(s)
Arterial Pressure/drug effects , Dietary Supplements , Docosahexaenoic Acids/administration & dosage , Eicosapentaenoic Acid/administration & dosage , Exercise , Hand Strength , Isometric Contraction , Adult , Aged , Drug Combinations , Exercise Test , Female , Healthy Volunteers , Heart Rate/drug effects , Humans , Male , Middle Aged , Time Factors , Treatment Outcome , Young AdultABSTRACT
The ability of the human body to maintain arterial blood pressure (BP) during orthostatic stress is determined by several reflex neural mechanisms. Renal vasoconstriction progressively increases during graded elevations in lower body negative pressure (LBNP). This sympathetically mediated response redistributes blood flow to the systemic circulation to maintain BP. However, how healthy aging affects the renal vasoconstrictor response to LBNP is unknown. Therefore, 10 young (25 ± 1 yr; means ± SE) and 10 older (66 ± 2 yr) subjects underwent graded LBNP (-15 and -30 mmHg) while beat-to-beat renal blood flow velocity (RBFV; Doppler ultrasound), arterial BP (Finometer), and heart rate (HR; electrocardiogram) were recorded. Renal vascular resistance (RVR), an index of renal vasoconstriction, was calculated as mean BP/RBFV. All baseline cardiovascular variables were similar between groups, except diastolic BP was higher in older subjects (P < 0.05). Increases in RVR during LBNP were greater in the older group compared with the young group (older: -15 mmHg Δ10 ± 3%, -30 mmHg Δ20 ± 5%; young: -15 mmHg Δ2 ± 2%, -30 mmHg Δ6 ± 2%; P < 0.05). RBFV tended to decrease more (P = 0.10) and mean BP tended to decrease less (P = 0.09) during LBNP in the older group compared with the young group. Systolic and diastolic BP, pulse pressure, and HR responses to LBNP were similar between groups. These findings suggest that aging augments the renal vasoconstrictor response to orthostatic stress in humans.
Subject(s)
Aging , Arterial Pressure , Baroreflex , Dizziness/physiopathology , Kidney/blood supply , Kidney/innervation , Vasoconstriction , Adaptation, Physiological , Adult , Age Factors , Aged , Blood Flow Velocity , Electrocardiography , Female , Heart Rate , Humans , Lower Body Negative Pressure , Male , Middle Aged , Renal Circulation , Ultrasonography, Doppler , Vascular Resistance , Young AdultABSTRACT
Increased central arterial stiffness and enhanced arterial wave reflections may contribute to increased risk of cardiovascular disease development with advancing age. Omega-3 polyunsaturated fatty acid (n-3) ingestion may reduce cardiovascular risk via favorable effects exerted on arterial structure and function. We determined the effects of n-3 supplementation (4 g/day for 12 weeks) on important measures of central arterial stiffness (carotid-femoral pulse wave velocity; PWV) and arterial wave reflection (central augmentation index) in young (n = 12; 25 ± 1-year-old, mean ± SE) and older (n = 12; 66 ± 2) healthy adults. We hypothesized that n-3 supplementation would decrease carotid-femoral PWV and central augmentation index in older adults. Our results indicate that carotid-femoral PWV and central augmentation index were greater in older (988 ± 65 cm/sec and 33 ± 2%) than in young adults (656 ± 16 cm/sec and 3 ± 4%: both P < 0.05 compared to older) before the intervention (Pre). N-3 supplementation decreased carotid-femoral PWV in older (∆-9 ± 2% Precompared to Post; P < 0.05), but not young adults (∆2 ± 3%). Central augmentation index was unchanged by n-3 supplementation in young (3 ± 4 vs. 0 ± 4% for Pre and Post, respectively) and older adults (33 ± 2 vs. 35 ± 3%). Arterial blood pressure at rest, although increased with age, was not altered by n-3 supplementation in young or older adults. Collectively, these data indicate that 12 weeks of daily n-3 supplementation decreases an important measure of central arterial stiffness (carotid-femoral PWV) in older, but not young healthy adults. The mechanism underlying decreased central arterial stiffness with n-3 supplementation is unknown, but appears to be independent of effects on arterial blood pressure or arterial wave reflections.
ABSTRACT
Exposure to acute heat or cold stress elicits numerous physiological responses aimed at maintaining body temperatures. Interestingly, many of the physiological responses, mediated by the cardiovascular and autonomic nervous systems, resemble aspects of, or responses to, certain disease states. The purpose of this Perspective is to highlight some of these areas in order to explore how they may help us better understand the pathophysiology underlying aspects of certain disease states. The benefits of using this human thermal stress approach are that (1) no adjustments for inherent comparative differences in animals are needed, (2) non-medicated healthy humans with no underlying co-morbidities can be studied in place of complex patients, and (3) more mechanistic perturbations can be safely employed without endangering potentially vulnerable populations. Cold stress can be used to induce stable elevations in blood pressure. Cold stress may also be used to model conditions where increases in myocardial oxygen demand are not met by anticipated increases in coronary blood flow, as occurs in older adults. Lower-body negative pressure has the capacity to model aspects of shock, and the further addition of heat stress improves and expands this model because passive-heat exposure lowers systemic vascular resistance at a time when central blood volume and left-ventricular filling pressure are reduced. Heat stress can model aspects of heat syncope and orthostatic intolerance as heat stress decreases cerebral blood flow and alters the Frank-Starling mechanism resulting in larger decreases in stroke volume for a given change in left-ventricular filling pressure. Combined, thermal perturbations may provide in vivo paradigms that can be employed to gain insights into pathophysiological aspects of certain disease states.
Subject(s)
Cold Temperature/adverse effects , Hot Temperature/adverse effects , Stress, Physiological , Cold-Shock Response/physiology , Heat Stress Disorders/physiopathology , Humans , Hypertension/physiopathology , Models, Biological , Myocardial Ischemia/physiopathologyABSTRACT
The chemoreflexes exert significant control over respiration and sympathetic outflow. Abnormalities in chemoreflex function may contribute to various disease processes. Based on prior animal studies, we developed the hypothesis that acutely elevating circulating angiotensin II levels into the pathophysiological range increases chemoreflex responsiveness in healthy humans. Eighteen adults were studied before (Pre) and during (Post) low (protocol 1; 2ng/kg/min; n=9) or high (protocol 2; 5ng/kg/min; n=9) dose angiotensin II infusion (study day 1). Chemoreflex responses were quantified by the pure nitrogen breathing method [slope of the minute ventilation vs. arterial oxygen saturation plot generated during a series (n=10) of 100% inspired nitrogen exposures (1-8 breaths)] and by measuring responses to hypercapnia (7% inspired carbon dioxide). Responses to a non-chemoreflex stimulus were also determined (cold pressor test). Measurements were repeated on a subsequent day (study day 2) before and during infusion of a control vasoconstrictor (phenylephrine) infused at a dose (0.6-1.2µg/kg/min) sufficient to increase blood pressure to the same degree as that achieved during angiotensin II infusion. We found that despite increasing plasma angiotensin II levels to pathophysiological levels responses to pure nitrogen breathing, hypercapnia, and the cold pressor test were unchanged by low (2ng/kg/min) and high dose (5ng/kg/min) angiotensin II infusion (protocols 1 and 2). Similarly, responses measured during phenylephrine infusion (Post) were unchanged (from Pre). These findings indicate that acutely increasing plasma angiotensin II levels to levels observed in disease states, such as human heart failure, do not increase chemoreflex responsiveness in healthy humans.
Subject(s)
Angiotensin II/pharmacology , Chemoreceptor Cells/physiology , Respiration/drug effects , Vasoconstrictor Agents/pharmacology , Adult , Angiotensin II/blood , Blood Pressure/drug effects , Blood Pressure/physiology , Carbon Dioxide/blood , Cold Temperature , Dose-Response Relationship, Drug , Female , Heart Rate/drug effects , Heart Rate/physiology , Hemodynamics/drug effects , Hemodynamics/physiology , Humans , Male , Nitrogen , Phenylephrine/pharmacology , Physical Stimulation , Vasoconstrictor Agents/blood , Young AdultABSTRACT
Excess dietary salt intake is a major contributing factor to the pathogenesis of salt-sensitive hypertension. Strong evidence suggests that salt-sensitive hypertension is attributed to renal dysfunction, vascular abnormalities, and activation of the sympathetic nervous system. Indeed, sympathetic nerve transections or interruption of neurotransmission in various brain centers lowers arterial blood pressure (ABP) in many salt-sensitive models. The purpose of this article is to discuss recent evidence that supports a role of plasma or cerebrospinal fluid hypernatremia as a key mediator of sympathoexcitation and elevated ABP. Both experimental and clinical studies using time-controlled sampling have documented that a diet high in salt increases plasma and cerebrospinal fluid sodium concentration. To the extent it has been tested, acute and chronic elevations in sodium concentration activates the sympathetic nervous system in animals and humans. A further understanding of how the central nervous system detects changes in plasma or cerebrospinal fluid sodium concentration may lead to new therapeutic treatment strategies in salt-sensitive hypertension.
Subject(s)
Central Nervous System/metabolism , Hypertension/etiology , Sodium Chloride, Dietary/adverse effects , Sympathetic Nervous System/metabolism , Animals , Blood Pressure/physiology , Central Nervous System/physiopathology , Humans , Sodium/blood , Sodium/cerebrospinal fluid , Sympathetic Nervous System/physiopathologyABSTRACT
The sympathetic nervous system is an important regulator of coronary blood flow. The cold pressor test (CPT) is a powerful sympathoexcitatory stressor. We tested the hypotheses that: (1) CPT-induced sympathetic activation elicits coronary vasodilatation in young adults that is impaired with advancing age and (2) combined α- and ß-adrenergic blockade diminishes/abolishes these age-related differences. Vascular responses of the left anterior descending artery to the CPT were determined by transthoracic Doppler echocardiography before (pre-blockade) and during (post-blockade) systemic co-administration of α- and ß-adrenergic antagonists in young (n = 9; 26 ± 1 years old, mean ± SEM) and older healthy men (n = 9; 66 ± 2 years old). Coronary vascular resistance (CVR; mean arterial pressure/coronary blood velocity) was used as an index of vascular tone. CPT decreased CVR (i.e. coronary vasodilatation occurred) in young ( -33 ± 6%), but not older men ( -3 ± 4%; P < 0.05 vs. young) pre-blockade. Adrenergic blockade abolished CPT-induced coronary vasodilatation in young men ( -33 ± 6% vs. 0 ± 6%, pre-blockade vs. post-blockade, respectively; P < 0.05) such that responses post-blockade mirrored those of older men ( -3 ± 4% vs. 8 ± 9%; both P > 0.05 compared to young pre-blockade). Impaired CPT-induced coronary vasodilatation could not be explained by a reduced stimulus for vasodilatation as group and condition effects persisted when CVR responses were expressed relative to myocardial oxygen demand (rate-pressure product). These data indicate that the normal coronary vascular response to sympathetic activation in young men is pronounced vasodilatation and this effect is lost with age as the result of an adrenergic mechanism. These findings may help explain how acute sympathoexcitation may precipitate angina and coronary ischaemic events, particularly in older adults.
Subject(s)
Coronary Vessels/physiology , Vasodilation , Vasomotor System/physiology , Adrenergic beta-Antagonists/pharmacology , Adult , Age Factors , Aged , Coronary Vessels/diagnostic imaging , Coronary Vessels/innervation , Humans , Male , Middle Aged , Ultrasonography , Vascular Resistance/drug effectsABSTRACT
Prospective studies indicate that high intake of dietary flavanols, such as those contained in cocoa/chocolate, are associated with reduced rates of cardiovascular-related morbidity and mortality in humans. Numerous mechanisms may underlie these associations such as favorable effects of flavanols on blood pressure, platelet aggregation, thrombosis, inflammation, and the vascular endothelium. The brachial artery flow-mediated dilation (FMD) technique has emerged as a robust method to quantify endothelial function in humans. Collectively, the preponderance of evidence indicates that FMD is a powerful surrogate measure for firm cardiovascular endpoints, such as cardiovascular-related mortality, in humans. Thus, literally thousands of studies have utilized this technique to document group differences in FMD, as well as to assess the effects of various interventions on FMD. In regards to the latter, numerous studies indicate that both acute and chronic ingestion of cocoa/chocolate increases FMD in humans. Increases in FMD after cocoa/chocolate ingestion appear to be dose-dependent such that greater increases in FMD are observed after ingestion of larger quantities. The mechanisms underlying these responses are likely diverse, however most data suggest an effect of increased nitric oxide bioavailability. Thus, positive vascular effects of cocoa/chocolate on the endothelium may underlie (i.e., be linked mechanistically to) reductions in cardiovascular risk in humans.
Subject(s)
Blood Circulation , Brachial Artery/physiology , Brachial Artery/physiopathology , Cacao/chemistry , Cardiovascular Diseases/physiopathology , Eating , Health , Vasodilation , HumansABSTRACT
Cardiovascular-related mortality increases in the cold winter months, particularly in older adults. Previously, we reported that determinants of myocardial O(2) demand, such as the rate-pressure product, increase more in older adults compared with young adults during cold stress. The aim of the present study was to determine if aging influences the coronary hemodynamic response to cold stress in humans. Transthoracic Doppler echocardiography was used to noninvasively measure peak coronary blood velocity in the left anterior descending artery before and during acute (20 min) whole body cold stress in 10 young adults (25 ± 1 yr) and 11 older healthy adults (65 ± 2 yr). Coronary vascular resistance (diastolic blood pressure/peak coronary blood velocity), coronary perfusion time fraction (coronary perfusion time/R-R interval), and left ventricular wall stress were calculated. We found that cooling (via a water-perfused suit) increased left ventricular wall stress, a primary determinant of myocardial O(2) consumption, in both young and older adults, although the magnitude of this increase was nearly twofold greater in older adults (change of 9.1 ± 3.5% vs. 17.6 ± 3.2%, P < 0.05, change from baseline in young and older adults and young vs. older adults). Despite the increased myocardial O(2) demand during cooling, coronary vasodilation (decreased coronary vascular resistance) occurred only in young adults (3.22 ± 0.23 to 2.85 ± 0.18 mmHg·cm(-1)·s(-1), P < 0.05) and not older adults (3.97 ± 0.24 to 3.79 ± 0.27 mmHg·cm(-1)·s(-1), P > 0.05). Consistent with a blunted coronary vascular response, absolute coronary perfusion time tended to decrease (P = 0.13) and coronary perfusion time fraction decreased (P < 0.05) during cooling in older adults but not young adults. Collectively, these data suggest that older adults demonstrate an altered coronary hemodynamic response to acute cold stress.
Subject(s)
Aging/physiology , Cold Temperature , Cold-Shock Response , Coronary Circulation , Coronary Vessels/physiology , Hemodynamics , Adaptation, Physiological , Adult , Age Factors , Aged , Analysis of Variance , Blood Flow Velocity , Blood Pressure , Coronary Vessels/diagnostic imaging , Echocardiography, Doppler, Color , Female , Humans , Male , Middle Aged , Myocardium/metabolism , Observer Variation , Oxygen Consumption , Pennsylvania , Regional Blood Flow , Reproducibility of Results , Skin Temperature , Time Factors , Vascular Resistance , Vasodilation , Young AdultABSTRACT
An inverse relation exists between intake of flavonoid-rich foods, such as cocoa, and cardiovascular-related mortality. Favorable effects of flavonoids on the endothelium may underlie these associations. We performed a randomized, double-blind, placebo-controlled study to test the hypothesis that acute cocoa ingestion dose dependently increases endothelium-dependent vasodilation, as measured by an increase in brachial artery flow-mediated dilation (FMD), in healthy older adults. Measurements were obtained before (preingestion) and after (1- and 2-h postingestion) ingestion of 0 (placebo), 2, 5, 13, and 26 g of cocoa in 23 adults (63 ± 2 yr old, mean ± SE). Changes in brachial artery FMD 1- and 2-h postingestion compared with preingestion were used to determine the effects of cocoa. FMD was unchanged 1 (Δ-0.3 ± 0.2%)- and 2-h (Δ0.1 ± 0.1%) after placebo (0 g cocoa). In contrast, FMD increased both 1-h postingestion (2 g cocoa Δ0.0 ± 0.2%, 5 g cocoa Δ0.8 ± 0.3%, 13 g cocoa Δ1.0 ± 0.3%, and 26 g cocoa Δ1.6 ± 0.3%: P < 0.05 compared with placebo for 5, 13, and 26 g cocoa) and 2-h postingestion (2 g cocoa Δ0.5 ± 0.3%, 5 g cocoa Δ1.0 ± 0.3%, 13 g cocoa Δ1.4 ± 0.2%, and 26 g cocoa Δ2.5 ± 0.4%: P < 0.05 compared with placebo for 5, 13, and 26 g cocoa) on the other study days. A serum marker of cocoa ingestion (total epicatechin) correlated with increased FMD 1- and 2-h postingestion (r = 0.44-0.48; both P < 0.05). Collectively, these results indicate that acute cocoa ingestion dose dependently increases brachial artery FMD in healthy older humans. These responses may help to explain associations between flavonoid intake and cardiovascular-related mortality in humans.
Subject(s)
Cacao , Vasodilation , Adult , Beverages , Blood Glucose/metabolism , Brachial Artery/drug effects , Brachial Artery/physiology , Catechin/blood , Dose-Response Relationship, Drug , Double-Blind Method , Eating , Endothelium, Vascular/drug effects , Endothelium, Vascular/physiology , Female , Flavonoids/administration & dosage , Hemodynamics/drug effects , Humans , Male , Middle Aged , Vasodilation/drug effectsABSTRACT
Limb venous compliance decreases with advancing age, even in healthy humans. To test the hypothesis that adrenergic mechanisms contribute to age-associated reductions in limb venous compliance, we measured calf venous compliance before and during acute systemic α- and ß-adrenergic blockade in eight young (27 ± 1 yr old, mean ± SE) and eight older healthy men (67 ± 2 yr old). Calf venous compliance was determined in supine subjects by inflating a thigh-collecting cuff to 60 mmHg for 8 min and then decreasing it (1 mmHg/s) to 0 mmHg while calf volume was indexed with a strain gauge. The slope (·10⻳) of the pressure-compliance relation (compliance= ß1 + 2·ß2·cuff pressure), which is the first derivative of the quadratic pressure-volume relation [(Δlimb volume) = ß0+ ß1·(cuff pressure) + ß2·(cuff pressure)²] during reductions in cuff pressure, was used to quantify calf venous compliance. Calf venous compliance was â¼30% lower (P < 0.01) in older compared with young men before adrenergic blockade. In response to adrenergic blockade calf venous compliance did not increase in young (-2.62 ± 0.14 and -2.29 ± 0.18 ml·dl⻹·mmHg⻹, before and during blockade, respectively) or older men (-1.78 ± 0.27 and -1.68 ± 0.21 ml·dl⻹ ·mmHg⻹). Moreover, during adrenergic blockade differences in calf venous compliance between young and older men observed before adrenergic blockade persisted. Collectively, these data strongly suggest that adrenergic mechanisms neither directly restrain calf venous compliance in young or older men nor do they contribute to age-associated reductions in calf venous compliance in healthy men.
Subject(s)
Aging/physiology , Receptors, Adrenergic/metabolism , Veins/physiology , Adult , Aged , Elasticity/physiology , Humans , Leg/blood supply , Male , Middle Aged , Vascular Resistance/physiologySubject(s)
Acetylcholine/administration & dosage , Cholinergic Fibers/physiology , Exercise/physiology , Sweat Glands/innervation , Sweat Glands/physiology , Adult , Cholinergic Agents/administration & dosage , Cholinergic Fibers/drug effects , Dose-Response Relationship, Drug , Humans , Oxygen Consumption/physiologyABSTRACT
To determine whether skin surface cooling increases left ventricular preload and contractility to a greater extent in older compared with young adults we studied 11 young (28 +/- 2 yr; means +/- SE) and 11 older (64 +/- 3 yr) adults during normothermia (35 degrees C water perfused through a tube-lined suit) and cooling (15 degrees C water perfused for 20 min) using standard and tissue Doppler echocardiography. Cooling significantly decreased skin surface temperature in young (Delta2.8 +/- 0.3 degrees C) and older (Delta3.0 +/- 0.3 degrees C) adults and increased rate-pressure product, an index of myocardial oxygen demand, in older (6,932 +/- 445 to 7,622 +/- 499 mmHg x beats/min for normothermia and cooling, respectively), but not young (7,085 +/- 438 to 7,297 +/- 438 mmHg x beats/min) adults. Increases in blood pressure (systolic and mean blood pressure) during cooling were greater (P < 0.05) in older than in young adults. Cooling increased preload in older (left ventricular end-diastolic volume from 106 +/- 7 to 126 +/- 9 ml and left ventricular internal diameter in diastole from 4.69 +/- 0.12 to 4.95 +/- 0.14 cm; both P < 0.01), but not young adults (left ventricular end-diastolic volume from 107 +/- 7 to 111 +/- 7 ml and left ventricular internal diameter in diastole from 4.70 +/- 0.10 to 4.78 +/- 0.10 cm). Indices of left ventricular contractility (ejection fraction, myocardial acceleration during isovolumic contraction, and peak systolic mitral annulus velocity) were unchanged during cooling in both young and older adults. Collectively, these data indicate that cooling increases left ventricular preload, without affecting left ventricular contractility in older but not young adults. Greater increases in preload and afterload during cooling in older adults contribute to greater increases in indices of myocardial oxygen demand and may help explain the increased risk of cardiovascular events in cold weather.
Subject(s)
Aging/physiology , Cold Temperature , Heart/physiology , Adult , Blood Pressure , Diastole/physiology , Echocardiography, Doppler , Humans , Stroke Volume/physiology , Systole/physiologyABSTRACT
Cardiovascular-related mortality peaks during cold winter months, particularly in older adults. Acute physiological responses, such as increases in blood pressure, in response to cold exposure may contribute to these associations. To determine whether the blood pressure-raising effect (pressor response) of non-internal body temperature-reducing cold stress is greater with age, we measured physiological responses to 20 min of superficial skin cooling, via water-perfused suit, in 12 younger [25 +/- 1 (SE) yr old] and 12 older (65 +/- 2 yr old) adults. We found that superficial skin cooling elicited an increase in blood pressure from resting levels (pressor response; P < 0.05) in younger and older adults. However, the magnitude of this pressor response (systolic and mean blood pressure) was more than twofold higher in older adults (P < 0.05 vs. younger adults). The magnitude of the pressor response was similar at peripheral (brachial) and central (estimated in the aorta) measurement sites. Regression analysis revealed that aortic pulse wave velocity, a measure of central arterial stiffness obtained before cooling, was the best predictor of the increased pressor response to superficial skin cooling in older adults, explaining approximately 63% of its variability. These results indicate that there is a greater pressor response to non-internal body temperature-reducing cold stress with age in humans that may be mediated by increased levels of central arterial stiffness.
Subject(s)
Aging , Aorta/physiology , Cold Temperature , Hemodynamics , Skin Temperature , Stress, Physiological , Adult , Age Factors , Aged , Aorta/diagnostic imaging , Blood Flow Velocity , Blood Pressure , Elasticity , Female , Heart Rate , Humans , Male , Manometry , Middle Aged , Pulsatile Flow , Regional Blood Flow , Time Factors , Ultrasonography, Doppler , Young AdultABSTRACT
Resting whole leg blood flow and vascular conductance decrease linearly with advancing age in healthy adult men. The potential role of age-related increases in oxidative stress in these changes is unknown. Resting leg blood flow during saline and ascorbic acid infusion was studied in 10 young (25 +/- 1 yr) and 11 older (63 +/- 2 yr) healthy normotensive men. Plasma oxidized LDL, a marker of oxidative stress, was greater in the older men (P < 0.05). Absolute resting femoral artery blood flow at baseline (iv saline control infusion) was 25% lower in the older men (238 +/- 25 vs. 316 +/- 38 ml/min; P < 0.05), and it was inversely related to plasma oxidized LDL (r = -0.56, P < 0.01) in all subjects. Infusion of supraphysiological concentrations of ascorbic acid increased femoral artery blood flow by 37% in the older men (to 327 +/- 52 ml/min; P < 0.05), but not in the young men (352 +/- 41 ml/min; P = 0.28), thus abolishing group differences (P = 0.72). Mean arterial blood pressure was greater in the older men at baseline (86 +/- 4 vs. 78 +/- 2 mmHg; P < 0.05), but it was unaffected by ascorbic acid infusion (P >/= 0.70). As a result, the lower baseline femoral artery blood flow in the older men was mediated solely by a 32% lower femoral artery vascular conductance (P < 0.05). Baseline femoral vascular conductance also was inversely related to plasma oxidized LDL (r = -0.65, P < 0.01). Ascorbic acid increased femoral vascular conductance by 36% in the older men (P < 0.05) but not in the young men (P = 0.31). In conclusion, ascorbic acid infused at concentrations known to scavenge reactive oxygen species restores resting femoral artery blood flow in healthy older adult men by increasing vascular conductance. These results support the hypothesis that oxidative stress plays a major role in the reduced resting whole leg blood flow and increased leg vasoconstriction observed with aging in men.
Subject(s)
Aging/metabolism , Ascorbic Acid/administration & dosage , Femoral Artery/drug effects , Free Radical Scavengers/administration & dosage , Leg/blood supply , Oxidative Stress/drug effects , Vasoconstriction/drug effects , Adult , Age Factors , Aged , Aging/blood , Ascorbic Acid/blood , Blood Flow Velocity/drug effects , Blood Pressure/drug effects , Dose-Response Relationship, Drug , Endothelin-1/blood , Epinephrine/blood , Femoral Artery/diagnostic imaging , Free Radical Scavengers/blood , Humans , Infusions, Intravenous , Lipoproteins, LDL/blood , Male , Middle Aged , Norepinephrine/blood , Reference Values , Regional Blood Flow/drug effects , Ultrasonography, Doppler, Duplex , Vascular Resistance/drug effects , Vasoconstrictor Agents/bloodABSTRACT
Skin-surface cooling elicits a pronounced systemic pressor response, which has previously been reported to be associated with peripheral vasoconstriction and may not fully account for the decrease in systemic vascular conductance. To test the hypothesis that whole body skin-surface cooling would also induce renal and splanchnic vasoconstriction, 14 supine subjects performed 26 skin-surface cooling trials (15-18 degrees C water perfused through a tube-lined suit for 20 min). Oral and mean skin temperature, heart rate, stroke volume (Doppler ultrasound), mean arterial blood pressure (MAP), cutaneous blood velocity (laser-Doppler), and mean blood velocity of the brachial, celiac, renal, and superior mesenteric arteries (Doppler ultrasound) were measured during normothermia and skin-surface cooling. Cardiac output (heart rate x stroke volume) and indexes of vascular conductance (flux or blood velocity/MAP) were calculated. Skin-surface cooling increased MAP (n = 26; 78 +/- 5 to 88 +/- 5 mmHg; mean +/- SD) and decreased mean skin temperature (n = 26; 33.7 +/- 0.7 to 27.5 +/- 1.2 degrees C) and cutaneous (n = 12; 0.93 +/- 0.68 to 0.36 +/- 0.20 flux/mmHg), brachial (n = 10; 32 +/- 15 to 20 +/- 12), celiac (n = 8; 85 +/- 22 to 73 +/- 22 cm.s(-1).mmHg(-1)), superior mesenteric (n = 8; 55 +/- 16 to 48 +/- 10 cm.s(-1).mmHg(-1)), and renal (n = 8; 74 +/- 26 to 64 +/- 20 cm.s(-1).mmHg(-1); all P < 0.05) vascular conductance, without altering oral temperature, cardiac output, heart rate, or stroke volume. These data identify decreases in vascular conductance of skin and of brachial, celiac, superior mesenteric, and renal arteries. Thus it appears that vasoconstriction in both peripheral and visceral arteries contributes importantly to the pressor response produced during skin-surface cooling in humans.