Impaired Renal Adaptation to Stress in the Elderly With Isolated Systolic Hypertension

Abstract —The aim of this study was to evaluate the renal response in the elderly with isolated systolic hypertension (ISH) when an adrenergic activation, as induced by mental stress, is applied. Renal hemodynamics and kidney neurohumoral response to mental stress were studied in 8 elderly patients with ISH (aged 63 to 82 years) along with 8 elderly normotensive subjects. The study encompassed four 30-minute experimental periods (baseline, mental stress, and recovery I and II). In these patients, the mental stress–induced blood pressure rise was associated with a significant increase in both effective renal plasma flow ( 131 I-labeled hippurate clearance) and glomerular filtration rate ( 125 I-labeled iothalamate clearance) (+42% and +29%, respectively; P 2 , and cGMP increased during the stimulus (+50%, +54%, and +59%, respectively; P