This study compared alterations in arterial catecholamine concentrations associated with tilt-induced vasovagal syncope that differed in older (>65 years) and younger patients (<35 years). Older patients with tilt-positive tests tended to exhibit higher baseline epinephrine (E) concentrations and lesser E surge before development of syncope than younger patients (<35 years), whereas both groups manifested comparable norepinephrine (NE) responsiveness.