Baseline shock index and baroreflex function in older adults

Aging and health research Pub Date : 2025-01-13 DOI:10.1016/j.ahr.2025.100220

Kenneth M. Madden , Boris Feldman , Graydon S. Meneilly

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Abstract

Elevations in shock index (SI), defined as heart rate (HR)/systolic blood pressure (BP) are less discriminative of impending shock in older adults. We hypothesized baroreflex dysfunction as a potential explanation for lower baseline SI in older adults. 52 older adults (29 women, 23 men, age ≥ 65; mean age 77.8 ± 0.9 years) were recruited. SI, the modified shock index (MSI, HR/mean BP), and the age corrected SI (Age * SI) as well as baroreflex function (using the sequence method) was measured at baseline. SI (Standardized β = 0.392, p = 0.005), MSI (Standardized β = 0.385, p = 0.006) and Age * SI (Standardized β = 0.431, p = 0.002) showed significant positive associations with BRS_up. Age * SI also showed a significant positive association with BRS (Standardized β = 0.329, p = 0.019). Autonomic dysfunction is associated with lower SI in older adults, potentially masking circulatory instability.

ClinicalTrials.gov ID NCT01914133

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老年人的基线休克指数和气压反射功能

休克指数（SI）的升高，定义为心率(HR)/收缩压（BP），对老年人即将发生的休克没有太大的区别。我们假设压力反射功能障碍是老年人较低基线SI的潜在解释。老年人52例(女性29例，男性23例，年龄≥65岁；平均年龄（77.8±0.9岁）。在基线时测量SI、修正冲击指数（MSI, HR/mean BP）、年龄校正SI （age * SI）以及气压反射函数（使用序列法）。SI（标准化β = 0.392, p = 0.005）、MSI（标准化β = 0.385, p = 0.006）、Age * SI（标准化β = 0.431, p = 0.002）与BRSup呈显著正相关。年龄* SI与BRS也呈显著正相关（标准化β = 0.329, p = 0.019）。自主神经功能障碍与老年人低SI相关，可能掩盖循环不稳定

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