Effect of Gender and age on cardiovascular autonomic function response to Head-Up Tilt test in Healthy adults
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Abstract
Background: Cardiovascular autonomic function preserves the hemodynamic stability after posture change and this is an adaptive response that can be studied using the Head-Up Tilt (HUT) test. Objective: This study aims to evaluate the age and gender dimorphism of cardiovascular autonomic responses and hemodynamic stability during the HUT test in healthy young adults.
Methods: This is a cross-sectional study of 100 healthy volunteers between the ages of 18-82 years. Following 10-minute supine rest period, patients were tilted at 70° for 5-10 minutes. Beat-to-beat continuous measurement of systolic blood pressure (SBP), diastolic blood pressure (DBP), and frequency-domain heart rate variability (HRV) parameters were measured non-invasively. These variables were further compared among gender and age (less than 25 years and 26-30 years) sub-groups. Results: Hemodynamic stability was maintained with insignificant differences in changes in SBP and DBP across gender and age groups. Gender-wise comparison of mean values revealed a higher LF/HF ratio during tilt (0.40 ± 0.02) in females as compared to males (0.18 ± 0.03, p < 0.001). This indicates sympathetic dominance in females whereas males showed significantly higher mean value of HF power (136,595.69 ± 7586.13 ms2). The group of age between 26 and 30 years had higher LF/HF ratio (0.33 ± 0.11) compared to less than 25 years old (0.23 ± 0.10). The group with age less than 25 years old showed a massive change in HF power (Δ 21,937.50 ± 9735.10 ms2) to attain cardiovascular homeostasis compared to other group (Δ 13,848.15 ± 9180.64 ms2, p = 0.001). Conclusions: Identical BP during orthostatic stress conceals different autonomic workload based on gender. Moreover, there is a shift towards increased sympathetic dominance and decreased parasympathetic reserve from early adulthood onwards. Understanding these sex and age-specific variations is essential to interpret the results of the HUT test and personalize the interpretation of results.
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