Although the chronotropic response to cough may provide an index of the capacity for cardioacceleration, how the heart rate change may be influenced by age is not established. In 213 healthy men and women aged 20-90 yr we measured the heart rate response following three forceful coughs performed over a 3-s period. Resting heart rate was not age related. Increasing age was associated with a linear reduction in cough-induced maximum rise in heart rate (r = -0.58, P less than 0.0001) and a prolongation of the time to peak heart rate (P less than 0.001). The responses were not different between women and men. Multiple regression analysis performed on age and systolic, diastolic, and mean basal arterial pressure measurements revealed that age was the sole variable that correlated significantly with peak heart rate response. Thus advancing age is associated with a decline in the amplitude and rapidity of the chronotropic response to cough. These age-related changes are independent of the basal arterial pressure and may contribute to the decreased cardiovascular homeostatic response to stress, such as upright posture or volume depletion, which is commonly observed in the elderly.