The Cardiovascular Dizziness Connection: Role of Vestibular Autonomic Interactions in Aging and Dizziness

Dizziness and vertigo symptoms are common across all ages. Although it is well known that vestibular dysfunction can cause these symptoms, other causes must also be considered. This chapter examines the role of blood pressure and cerebral blood flow regulation and their possible connections to the development of dizziness. Humans have several cardiovascular adaptations that are designed to maintain blood pressure and brain blood flow when upright. The role of the baroreflex in maintaining blood pressure when moving from the supine to upright position is reviewed. Brain blood flow regulation to maintain adequate flow when upright also has been examined. Reductions in brain blood flow have been shown to be associated with the development of dizziness as well as orthostatic hypotension. In addition, there is emerging evidence that the vestibular system assists in this cardiovascular adaptation. Therefore, it is important to consider how vestibular dysfunction may result in orthostatic hypotension or reduced brain blood flow that could cause or worsen symptoms of dizziness.