ObjectiveHealthy centenarians have a greater molar ratio of plasma insulin-like growth factor-1 to insulin-like growth factor binding protein-3 than that of aged subjects. We investigated the question of whether differences in mean arterial pressure and in this plasma ratio were related in healthy centenarians.Subjects and methodsWe studied 52 subjects in total, 30 aged subjects (70–99 years) and 22 healthy centenarians (> 100 years) to determine differences in mean arterial pressure, endothelial function and intracellular cation levels.ResultsIn the healthy centenarians, the molar ratio of fasting plasma insulin-like growth factor-1 to its binding protein-3 was significantly correlated with mean arterial pressure (r= −0.66,P< 0.001). Baseline (19.3 ± 1.5 versus 27.6 ± 2.2 μmol/l,P< 0.05) and L-arginine-stimulated percentage increases in the plasma total nitrate : nitrite ratio (67 ± 3.4 versus 48 ± 4.5%,P< 0.03) were greater in the healthy centenarians than in the aged subjects. An L-arginine bolus elicited an increase in forearm blood flow which was correlated with the percentage increase in the plasma total nitrate : nitrite ratio (r= 0.79,P< 0.001) and with the fasting erythrocyte magnesium concentration (r= 0.80,P< 0.001) in healthy centenarians. Both correlations remained significant (P< 0.01) after adjustment for sex, body mass index and the waist : hip ratio. Moreover, the fasting plasma molar ratio of insulin-like growth factor-1 to its binding protein-3 was correlated with the percentage increase in forearm blood flow (r= 0.59,P< 0.005) and with the percentage increase in the plasma total nitrate : nitrite ratio (r= 0.54,P< 0.009) in healthy centenarians. The centenarians had higher baseline total erythrocyte magnesium and lower calcium concentrations than the aged subjects. The addition of insulin growth factor-1 to the incubation medium increased the total intracellular erythrocyte magnesium content and decreased the calcium content in both groups of subjects. Nevertheless, the percentage increase in total erythrocyte magnesium (33 ± 3.8 versus 12 ± 3.4%,P< 0.03) and decline in intracellular calcium (17 ± 2.8 versus 8 ± 3.1%,P< 0.02) concentrations were greater in the healthy centenarians than the aged subjects.ConclusionIn healthy centenarians, insulin-like growth factor-1 may preserve endothelial function and modulate the intracellular cation content, thus contributing to a lower mean arterial pressure than that in aged subjects.