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© 1987 Oxford University Press

research-article

REDUCED PLASMA RENIN ACTIVITY IN ELDERLY SUBJECTS IN RESPONSE TO VASOVAGAL HYPOTENSION AND HEAD-UP TILT

ROSE ANNE KENNY, Research Fellow in Cardiology1, CALUM C. LYON, Laboratory Technician Medical Unit2, JOHN BAYLISS, Senior Registrar in Cardiology2, STAFFORD L LIGHTMAN, Senior Lecturer Medical Unit2 and RICHARD SUTTON, Consultant Cardiologist2

1Cardliology Department, Charing Cross and Westminster Medical School, Westminster Hospital London
2Cardliology Department, Charing Cross and Westminster Medical School, Westminster Hospital London

The sympathoadrenal and renin-angiotensin systems play an important role in the cardiovascular responses induced by head-up tilt. In young people, hypotension and postural changes induced by tilt produce significant increases in plasma renin activity. The response of plasma renin activity to prolonged tilt and subsequent vasovagal hypotension has not been assessed in the elderly.

Seventeen elderly subjects (10 with carotid sinus syndrome and seven age-matched controls) were studied during 45 minutes of recumbency and 120 minutes of head-up tilt to 40°. Intra-arterial systolic blood pressure and heart rate were monitored continuously and plasma renin activity was measured at frequent intervals.

Ten subjects developed vasovagal syncope during tilt (at 32±18 min). Systolic blood pressure and heart rate fell by 70±20 mmHg and 20±7 beats.min–1 (P<0.001 and P<0.01, respectively). Plasma renin activity did not change in syncopal subjects and remained unchanged up to 60 min after syncope. In seven subjects who completed 120 min of tilt without symptoms, heart rate rose during tilt but plasma renin activity remained unchanged.

Plasma renin activity is not influenced by marked hypotension or prolonged head-up tilt in the elderly.

accepted in revised form November 27, 1986.


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