Hypotensive response to atrial natriuretic peptide administration is enhanced with age

J. M. Hausdorff, B. A. Clark, R. P. Shannon, D. Elahi, J. Y. Wei*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background. Plasma levels of atrial natriuretic peptide (ANP) increase with age. To test the hypothesis that the cardiovascular response to ANP is age dependent and to examine the role of the increased levels of ANP in the hypotensive response to orthostatic challenge, we compared the hemodynamic response of young and elderly subjects to ANP infusion and orthostatic challenge. Methods. Blood pressure, heart rate, forearm cutaneous resistance, plasma ANP, and plasma norepinephrine were measured in the supine position and following upright tilt before and after a 60-minute infusion of atrial natriuretic peptide (0.05 μg/kg/min) in 7 young (27 ± 4 years) and 5 elderly (74 ± 4 years) normotensive, healthy subjects. Results. Prior to ANP infusion, the response to upright tilt was similar in both groups. Infusion of ANP produced similar steady state plasma levels of ANP in both groups (young: 435 ± 49 pg/ml; elderly: 429 ± 32 pg/ml). Supine systolic blood pressure decreased by 4 ± 2 mmHg in the young subjects and by 18 ± 8 mmHg in the elderly subjects after infusion (p < .08). In contrast, changes in supine heart rate, forearm cutaneous resistance, and plasma norepinephrine were similar in both groups (Δ heart rate: young +5 ± 3 beats/min, elderly + 4 ± 2 beats/min; Δ forearm cutaneous resistance: young -38 ± 9%, elderly -40 ± 6%; Δ norepinephrine: young +55 ± 11%, elderly: +43 ± 13%). ANP infusion abolished the vasoconstrictor response normally associated with orthostatic challenge in both groups, despite a significant release of catecholamines and an enhanced heart rate response. This resulted in significant systolic blood pressure reduction in both young (-7 ± 2 mmHg, p < .05) and elderly subjects (-16 ± 4 mmHg, p < .05). The drop in systolic blood pressure in response to upright tilt and ANP infusion was four times larger in the elderly subjects (change from pre-ANP level: young -8 ± 3 mmHg, elderly -32 ± 5 mmHg, p < .005). Conclusion. Advanced age is associated with a greater hypotensive response to atrial natriuretic peptide infusion.

Original languageEnglish
Pages (from-to)M169-M172
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume50
Issue number3
DOIs
StatePublished - 1995
Externally publishedYes

Funding

FundersFunder number
National Institute on AgingP60AG008812

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