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a Department of Geriatric Medicine, University Medical Center Nijmegen, the Netherlands
René W.M.M. Jansen, University Medical Center Nijmegen, 318, Department of Geriatric Medi-cine, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands E-mail: R.Jansen{at}czzoger.azn.nl.
Decision Editor: John E. Morley, MB, BCh
Background. Postprandial hypotension (PPH) is a common and serious disorder of blood pressure (BP) regulation in elderly people. It has been suggested that primarily the carbohydrate (CH) content of a meal induces the BP decrease. Therefore, we examined the relationship between the CH content of meals and postprandial BP responses in elderly patients diagnosed with PPH.
Methods. Twelve geriatric patients (aged 75 to 91 years; 6 men) who were previously diagnosed with PPH received standardized liquid meals with low- (25 g), normal- (65 g), and high- (125 g) CH content in random order on three separate days. Systolic BP (SBP), diastolic BP, and heart rate were measured every 5 minutes from 20 minutes before until 75 minutes after each meal. Postprandial symptoms were recorded every 15 minutes.
Results. The maximum decrease in SBP was significantly smaller after the low-CH meal (-28 ± 5 mm Hg) than after the normal- (-39 ± 7 mm Hg) and high-CH meals (-40 ± 5 mm Hg) (p < .050 between groups). In addition, the duration of PPH was significantly shorter (p < .010), and postprandial symptoms were less frequent and less severe after the low-CH meal.
Conclusions. Reducing the CH amount in meals induces significantly smaller decreases in SBP, shorter duration of PPH, and reduction of PPH-related symptoms. Therefore, limiting the CH content of an elderly patient's meal can be a clinically effective nonpharmacological treatment for PPH in elderly patients and can reduce the risk of developing symptomatic PPH.
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