Educating older men and women about the dangers of hypertension could increase their blood pressure control

2003 ◽  
2019 ◽  
Vol 317 (2) ◽  
pp. H315-H322 ◽  
Author(s):  
Jason R. Carter ◽  
Ida T. Fonkoue ◽  
Ian M. Greenlund ◽  
Christopher E. Schwartz ◽  
Babak Mokhlesi ◽  
...  

Our laboratory has previously reported that total sleep deprivation (TSD) modifies muscle sympathetic neural activity (MSNA) differently in young men and women. Because postmenopausal women are among the highest risk for hypertension, this study compares MSNA responses with TSD in older men and women. We hypothesized that TSD would alter MSNA in older adults, with greater sympathoexcitation in postmenopausal women. Twenty-seven participants (14 men and 13 women) between the ages of 55 and 75 yr were tested twice, once after 24-h TSD and once after normal sleep (randomized, crossover design). Our primary outcome measure of MSNA (microneurography) was successful across both conditions in 20 participants (10 men and 10 women). Secondary outcome measures included seated blood pressure, heart rate, and fasting plasma testosterone, estradiol, and progesterone. Age (60 ± 1 vs. 61 ± 2 yr) and BMI (27 ± 1 vs. 26 ± 1 kg/m2) were not different between groups. TSD increased systolic blood pressure in both men (124 ± 5 to 130 ± 4 mmHg) and women (107 ± 5 to 116 ± 4 mmHg), but the increases were not different between groups (condition, P = 0.014; condition × sex, P > 0.05). In contrast, TSD elicited divergent MSNA responses in older men and women. Specifically, MSNA burst frequency increased in postmenopausal women (28 ± 3 to 34 ± 3 burst/min), but not older men (38 ± 3 to 35 ± 3 bursts/min; condition × sex, P = 0.032). In conclusion, TSD elicited sympathoexcitation in postmenopausal women but not age-matched men. These findings provide new mechanistic insight into reported links between sleep deprivation and hypertension. NEW & NOTEWORTHY Epidemiological studies report that sleep deprivation is more strongly associated with hypertension in women than in men. In the present study, 24-h total sleep deprivation (TSD) increased blood pressure in postmenopausal women and age-matched men. In contrast, only women demonstrated increases in muscle sympathetic nerve activity after TSD. The sympathoexcitation observed in postmenopausal women suggests a potential contributing mechanism for epidemiological observations and advances our understanding of the complex relations between sleep, sex, and hypertension. Listen to this article’s corresponding podcast at https://ajpheart.podbean.com/e/total-sleep-deprivation-and-msna-in-older-adults/ .


2020 ◽  
pp. 1-7
Author(s):  
M.J. BENTON ◽  
A.L. SILVA-SMITH ◽  
J.M. SPICHER

Background: Muscle provides a reservoir for water to maintain fluid volume and blood pressure, so older adults may be at risk for orthostatic hypotension due to muscle loss with age. Objectives: To evaluate the association between muscle loss with age and postural blood pressure. Design: Longitudinal comparison of overnight changes in hydration, postural blood pressure, and strength. Setting: Community field study. Participants: Sixty-nine men and women (76.0 ± 0.8 years) with low (Low) or normal (Normal) muscle based on the Lean Mass Index. Measurements: Body composition was measured with bioelectrical impedance analysis. Postural blood pressure was measured sequentially (lying, sitting, standing). Strength was measured with a handgrip dynamometer, Arm Curl test, and Chair Stand test. Results: On Day 1, Low had less hydration and a significant drop in postural systolic blood pressure compared to Normal (lying to standing: -11.06 ± 2.36 vs. +1.14 ± 2.20 mmHg, p < 0.001). Overnight, both groups lost significant total body water, while fluid volume was unchanged. On Day 2, both groups experienced significant drops in postural systolic blood pressure, although the drop in Low was more profound and significantly greater than Normal (lying to standing: -16.85 ± 2.50 vs. -3.89 ± 2.52 mmHg, p = 0.001). On both days, Normal compensated for postural changes with increases in postural diastolic blood pressure not observed in Low. Only Low experienced significant overnight decreases in all strength measures. Conclusions: In older men and women, muscle loss with age is accompanied by loss of hydration and less stable early morning postural systolic blood pressure that increase risk for orthostatic hypotension and can also increase risk for falls.


Hypertension ◽  
1999 ◽  
Vol 33 (3) ◽  
pp. 869-873 ◽  
Author(s):  
Valentina Rakic ◽  
Valerie Burke ◽  
Lawrence J. Beilin

Author(s):  
Benoît Verdon

Since the 1950s, the growing interest of clinicians in using projective tests to study normal or pathological aging processes has led to the creation of several thematic tests for older adults. This development reflects their authors’ belief that the TAT is not suitable to the concerns and anxieties of elderly persons. The new material thus refers explicitly to situations related to age; it aims to enable older persons to express needs they cannot verbalize during consultations. The psychodynamic approach to thematic testing is based on the differentiation between the pictures’ manifest and latent content, eliciting responses linked to mental processes and issues the respondent is unaware of. The cards do not necessarily have to show aging characters to elicit identification: The situations shown in the pictures are linked to loss, rivalry, helplessness, and renunciation, all issues elderly respondents can identify with and that lead them to express their mental fragilities and resources. The article first explains the principles underlying four of these thematic tests, then develops several examples of stories told for card 3BM of the TAT, thus showing the effectiveness of this tool for the understanding and differentiation of loss-related issues facing older men and women.


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