Effects of age and blood pressure on the cardiovascular responses to the Valsalva maneuver.

The present study was performed to obtain basic information as to the influences of two fundamental variables, age and blood pressure, on the circulatory responses during the Valsalva maneuver. Although a positive linear relationship between age and resting systolic blood pressure was present in the study population of 90 normal and uncomplicated hypertensive subjects, the pressure overshoot and the change in R-R intervals during phase 4 in the Valsalva maneuver were significantly inversely related to age or resting systolic blood pressure independently of each other variable. Furthermore, age was related negatively to the maximum R-R interval in phase 4 and positively to the decline of blood pressure post-Valsalva release in phase 3 even after adjusting for the effect of blood pressure, but age-independent relationships between these two indexes and resting systolic blood pressure were not statistically significant. The data indicate that changes in circulatory responses to the Valsalva maneuver occur with aging and high blood pressure, suggesting that the sympathetic vasoregulation and the baroreflex control of heart rate in the maneuver are impaired by these two variables. Such alterations appear to be more strongly related to age than to blood pressure level.