Cardiovascular autonomic reflex tests: normal responses and age-related reference values.

One hundred and forty-three healthy unmedicated subjects from a random sample, aged 20-80 years, were examined and cardiovascular autonomic function tests (Valsalva manoeuvre, deep and quiet breathing tests and active orthostatic test) were performed in order to study normal responses to these tests and to determine age-related reference values. Most of the cardiovascular indices reflecting autonomically mediated heart rate responses decline with advancing age and this leads inevitably to the need for age-related reference values. The indices are in general independent of sex but most indices are dependent on resting heart rate. The inter-individual variation is very marked so that the normal ranges are wide, and because the indices diminish with age, the lower reference values are less suitable for use in aged subjects. The reference values make it possible to use the indices for diagnostic purposes in young and middle-aged subjects (up to 65 years), whereas in older subjects the indices can be used in order to exclude autonomic disturbances. Reproducibility of heart rate indices is satisfactory or good whereas reproducibility of blood pressure indices is poor.