Effect of Age on Vascular α-Adrenoceptor Responsiveness in Man

Abstract

1. The responsiveness of α-receptors was compared in six young and six healthy elderly subjects by evaluating the haemodynamic effects of the a, antagonist prazosin and the pressor responses to the a, agonist phenylephrine. 2. Oral prazosin (1 mg) lowered erect (but not supine) blood pressure in both groups by a comparable amount: in young and old groups the respective maximal falls in systolic pressure were 19.5 ± 15.7 and 29.3 ± 11.4 mmHg (mean ± sd) and for diastolic pressure the maximal falls were 13 ± 13.3 and 18 ± 11.1 mmHg. 3. This similar fall in blood pressure occurred in association with a significantly different heart rate response: in the young group mean heart rate increased to 103 beats/min but there was no corresponding increase in the elderly group, which had a mean heart rate of 80 beats/min. 4. Log dose-response curves were derived from incremental intravenous infusions of phenylephrine, and the doses required to raise mean arterial pressure by 20 mmHg (PD20) were compared: the mean PD20 was significantly different in the two groups: 2.5 ± 1.6 in the young compared with 4.6 ± 2.3 μg min−1 kg−1 in the elderly, consistent with reduced pressor responsiveness in the elderly. 5. No significant difference in PD20 was apparent when pressor responsiveness was determined after prazosin, but the elderly required a significantly smaller increase in phenylephrine dosage to overcome prazosin's α-receptor-blocking effects. 6. Although there is no evidence of an age-related increase in the sensitivity of α-adrenoceptor-mediated vasoconstriction, the results are not inconsistent with an age-related reduction in α-adrenoceptor responsiveness.