1. The circulatory adjustment to standing was investigated in two age groups. Young subjects consisted of 20 healthy 10–14-year-old girls and boys. Elderly subjects consisted of 40 70–86-year-old healthy and active females and males. Continuous responses of blood pressure and heart rate were recorded by Finapres. A pulse contour algorithm applied to the finger arterial pressure waveform was used to assess stroke volume responses.
2. During the first 30 s (initial phase), an almost identical drop in mean blood pressure was found in both age groups (young, 16 ± 10 mmHg; old, 17 ± 10 mmHg), but the initial heart rate increase was attenuated in the elderly subjects (young, 29 ± 7 beats/min; old, 17 ± 7 beats/min).
3. During the period from 30 s to 10 min of standing, mean blood pressure increased from 96 ± 12 to 106 ± 12 mmHg in the elderly subjects compared with almost no change in the young subjects (from 82 ± 8 to 84 ± 7 mmHg). In the elderly subjects a progressive increase in total peripheral resistance (from 114 ± 14% to 146 ± 29%) was found, compared with an initial rapid increase in total peripheral resistance (126 ± 18% after 30 s) with no further change during prolonged standing (124 ± 17% after 10 min) in the young subjects. In this age group the decrease in stroke volume and the increase in heart rate after 10 min of standing were large (young, −37 ± 11% and 27 ± 11 beats/min; old, −31 ± 9% and 7 ± 6 beats/min, respectively).
4. In conclusion, young subjects adjust to orthostatic stress mainly by a marked increase in heart rate. In healthy elderly subjects an attenuation of the heart rate response during orthostatic stress is compensated by a pronounced increase in total peripheral resistance resulting in an increase in blood pressure.