Postural hypotension in old age: is it a disorder of the nervous system or of blood vessels?

Beat to beat variation, postural changes in blood pressure and thresholds for vibration sense were measured in 10 young adults and 186 old people living at home. There was a reduction in beat to beat variation, but and increase in postural changes in blood pressure and thresholds for vibration sense in the elderly. Within age and sex groups, there was no correlation between beat to beat variation, postural changes in blood pressure and thresholds for vibration sense, but a strong positive correlation between postural changes in blood pressure and lying systolic pressures. This suggests that, in old age, a change in the structure of the vascular tree may be more important than autonomic dysfunction, as a determinant of postural hypotension.