Clinical Autonomic Research

, Volume 25, Issue 5, pp 317–326 | Cite as

Sex and age effects on cardiovascular autonomic function in healthy adults

  • Jean-Pierre Ndayisaba
  • Alessandra Fanciulli
  • Roberta Granata
  • Susanne Duerr
  • Florian Hintringer
  • Georg Goebel
  • Florian Krismer
  • Gregor K. Wenning
Research Article



To determine the effects of sex and age on cardiovascular autonomic parameters in healthy adults as assessed by Finapres (finger arterial pressure) method and prolonged head-up tilt (HUT).


We enrolled 81 healthy volunteers (41 females, 40 males, 18–74 years) for extensive cardiovascular autonomic function testing including blood pressure (BP) recordings, electrocardiography, and impedance cardiography at rest, under 60° HUT for 45 min, active standing for 5 min, Valsalva maneuver, and deep breathing (DB). Mean values and orthostatic changes, i.e., differences to baseline, of heart rate (HR), systolic and diastolic BP, stroke volume (SV), and total peripheral resistance (TPR), as well as DB ratio and Valsalva ratio were calculated. A generalized linear model (extended by generalized estimating equations) was used to assess sex- and age-related differences.


Mean HR at rest was higher in women than in men (p = 0.035). In men, we observed significantly higher mean BP at rest (p < 0.001 systolic and p = 0.004 diastolic) and during HUT (p = 0.001 systolic and p < 0.001 diastolic), mean TPR at rest (p = 0.034), and mean SV during HUT (p < 0.001). We found no significant impact of sex on orthostatic changes of HR and BP. Mean TPR during HUT increased with age (p = 0.001), particularly in older women. Orthostatic changes of HR and diastolic BP, DB ratio, and Valsalva ratio became attenuated with age (p = 0.018, p = 0.006, p < 0.001, and p < 0.001, respectively).


Our study suggests that aging rather than sex needs to be taken into account when interpreting HR and BP changes during prolonged HUT performance.


Sex and age effects Cardiovascular autonomic function Head-up tilting Valsalva maneuver Deep breathing 



We thank all subjects who took part in the present study, for their patience and stamina. This study was supported by grants of the Austrian Science Fund (FWF): F04404-B19 and KLI380. The funder had neither a role in study design, data collection, and analysis, nor in the decision to publish or in the preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Supplementary material

10286_2015_310_MOESM1_ESM.pdf (543 kb)
Supplementary material 1 (PDF 544 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Jean-Pierre Ndayisaba
    • 1
    • 5
  • Alessandra Fanciulli
    • 1
    • 2
  • Roberta Granata
    • 1
  • Susanne Duerr
    • 1
  • Florian Hintringer
    • 3
  • Georg Goebel
    • 4
  • Florian Krismer
    • 1
  • Gregor K. Wenning
    • 1
    • 5
  1. 1.Department of NeurologyMedical University of InnsbruckInnsbruckAustria
  2. 2.Department of Neuroscience, Mental Health and Sensory Organs“Sapienza” University of RomeRomeItaly
  3. 3.Department of CardiologyMedical University of InnsbruckInnsbruckAustria
  4. 4.Department of Medical Statistics, Informatics and Health EconomicsMedical University of InnsbruckInnsbruckAustria
  5. 5.Division of Neurobiology, Department of NeurologyMedical University of InnsbruckInnsbruckAustria

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