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- Title
Vascular limitations in blood pressure regulation with age in women: Insights from exercise and acute cardioselective β‐blockade.
- Authors
Studinski, Matthew J.; Bowlus, Christine; Pawelczyk, James A.; Delgado Spicuzza, Jocelyn M.; Gosalia, Jigar; Mookerjee, Swapan; Muller, Matthew D.; Fragin, Jason; Proctor, David N.
- Abstract
Younger women rely on altering cardiac output (Q̇$\dot{Q}$) to regulate blood pressure (BP). In contrast, older women rely more on altering vascular tone. However, evidence suggests that the ability to alter systemic vascular conductance (SVC) is diminished in older women. In the present study, cardioselective β‐blockade was utilized to diminish the relative contribution of Q̇$\dot{Q}$ to BP regulation and thereby evaluate age‐related vascular limitations in women at rest and during large muscle dynamic exercise. Younger (n = 13, mean age 26.0 years) and older (n = 14, mean age 61.8 years) healthy women performed submaximal bouts of semi‐recumbent cycling exercise at varying intensities while receiving an intravenous infusion of esmolol, a β1‐antagonist, or saline control in a repeated‐measures crossover design. Q̇$\dot{Q}$ was attenuated during esmolol infusion, with greater reductions during exercise (moderate, –1.0 (95% CI, –1.6 to –0.5) L/min, P < 0.001; heavy, –2.0 (95% CI, –2.6 to –1.5) L/min, P < 0.001) than seated rest (–0.5 (95% CI, –1.1 to 0.0) L/min, P = 0.048), and this reduction was not significantly different between age groups (P = 0.122). Older women exhibited a greater attenuation in mean arterial pressure (MAP) during esmolol (–7 (95% CI, –9 to –4) mmHg, P < 0.001) relative to younger women (–2 (95% CI, –5 to 0) mmHg, P = 0.071). These changes coincided with a greater reduction of SVC in the younger women during esmolol (–15 (95% CI, –20 to –10) mL/min/mmHg, P < 0.001) compared to older women (–3 (95% CI, –9 to 2) mL/min/mmHg, P = 0.242). Together, these findings provide evidence that older, postmenopausal women have a diminished ability to adjust SVC in order to regulate MAP. What is the central question of this study?Will older women have a greater reduction in mean arterial pressure during cardioselective β‐blockade compared to younger women? And will older women exhibit a smaller reduction in systemic vascular conductance in response to cardioselective β‐blockade relative to younger women?What is the main finding and its importance?Cardioselective β‐blockade revealed a limitation in the systemic vasoconstrictor capacity of older women to maintain blood pressure both at rest and during dynamic exercise. These findings may have significant clinical implications, particularly during hypotensive stressors such as heat stress, hypovolemia and orthostatic hypotension.
- Subjects
OLDER women; REGULATION of blood pressure; AGE groups; ORTHOSTATIC hypotension; YOUNG women
- Publication
Experimental Physiology, 2025, Vol 110, Issue 1, p93
- ISSN
0958-0670
- Publication type
Academic Journal
- DOI
10.1113/EP091843