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Sauder G. Orthostatic (Postural) and Postprandial Hypotension in Older Adults. GERIATRIC MEDICINE 2024:401-409. [DOI: 10.1007/978-3-030-74720-6_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Dieffenbach SS, Shoval HA. Treatment of postprandial hypotension with acarbose in an adult with cervical spinal cord injury: a case report. Spinal Cord Ser Cases 2023; 9:56. [PMID: 38110351 PMCID: PMC10728054 DOI: 10.1038/s41394-023-00613-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/20/2023] Open
Abstract
INTRODUCTION Postprandial hypotension is a type of autonomic dysfunction where there is a decrease in systolic blood pressure of >20 mm HG within 2 h after eating thought to be due to poor cardiovascular compensation for splanchnic blood pooling that occurs with meals. This form of autonomic dysfunction is underdiagnosed in patients with spinal cord injury, likely in part because it can be asymptomatic. CASE PRESENTATION 26-year-old with complete cervical spinal cord injury (SCI) presented with neck pain described as severe 10/10 pain, which felt like "a rope around his neck." Pain came on during and after meals and was associated with a feeling of pressure behind his eyes, white spots in his vision along with feeling as if he was going to pass out. The caregiver noted a systolic blood pressure drop by about 30-40 points with meals and lost weight due to avoiding eating. A diagnosis of post-prandial hypotension (PPH) was made and Acarbose was started at a low dose 25 mg three times per day with meals. During follow up, the patient reported complete resolution of drops of blood pressure, neck pain, and all associated symptoms. The patient was able to eat comfortably and gained weight. DISCUSSION There are few case reports on PPH in SCI and none looking at acarbose on a young, nondiabetic person with SCI. Clinicians should be aware that PPH can occur in young otherwise healthy people with SCI. Further research is needed on PPH, including the use of acarbose, in the SCI population.
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Affiliation(s)
- Sabrina S Dieffenbach
- Physical Medicine and Rehabilitation Department, Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Hannah Aura Shoval
- Physical Medicine and Rehabilitation Department, Rutgers New Jersey Medical School, Newark, NJ, USA
- Pediatric Physical Medicine and Rehabilitation Department, Atlantic Health System, Morristown, NJ, USA
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Huang L, Cheng L, Xie X, Pu L, Jiang W, Zou Y, Zhang F. Non-pharmacological interventions for older adults with postprandial hypotension: A scoping review. J Clin Nurs 2023; 32:5974-5987. [PMID: 37219354 DOI: 10.1111/jocn.16719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/06/2023] [Accepted: 04/05/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Older adults frequently suffer from postprandial hypotension, associated with an increased risk of falls, syncope, acute cardiovascular and cerebrovascular diseases, and even death. Researchers use non-pharmacological interventions, but related literature is dispersed and lacks a latest summary. OBJECTIVE The aim of this study was to map and examine non-pharmacological interventions currently employed to assist older adults with postprandial hypotension and lay a solid foundation for future studies. METHODS This study adhered to the JBI methodology for scoping reviews and preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. PubMed, Web of Science, Embase, Cochrane Library, CINAHL, SCOPUS, Chinese Biomedical Journal, China National Knowledge Infrastructure, VIP and WAN FANG Data were retrieved from their inception to 1 August 2022. RESULTS Two randomized controlled trials and seven quasi-experimental studies were included. Small meals, exercise interventions, fibre with meals, green tea and water therapy have been reported to prevent postprandial hypotension effectively; however, position changes have been reported to have no impact on postprandial blood pressure decrease. Additionally, the blood pressure determination methods and test meals may affect observed trial effects. CONCLUSION Large samples and long-term follow-up studies are needed to prove the efficacy and safety of existing non-pharmacological interventions. Future studies should develop a BP determination method based on the postprandial BP decline trajectory induced by a given test meal to improve the reliability of study results. RELEVANCE TO CLINICAL PRACTICE This review broadly summarizes existing studies on developing and validating non-pharmacological interventions for older adults with postprandial hypotension. It also analyses special factors that may influence the trial effects. This may provide a useful reference for future research.
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Affiliation(s)
- Lei Huang
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, Chengdu, China
| | - Linan Cheng
- School of Nursing, Soochow University, Suzhou, China
| | - Xiaofeng Xie
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, Chengdu, China
| | - Lihui Pu
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Wenyi Jiang
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, Chengdu, China
| | - Ying Zou
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, Chengdu, China
| | - Fengying Zhang
- West China School of Nursing/Nursing Key Laboratory of Sichuan Province/Innovation Center of Nursing Research/West China Hospital, Sichuan University, Chengdu, China
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Lu F, Liu Y, Xiao Z, Wu S, Wu Q, Lin K, Yang K, Li X. Study on the effects of different postprandial positions on blood pressure and heart rate in older adults with primary hypertension and postprandial hypotension. Geriatr Nurs 2022; 46:199-205. [PMID: 35749864 DOI: 10.1016/j.gerinurse.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 12/01/2022]
Abstract
This randomized controlled trial explored the effects of a supine position or a semi-fowler position on postprandial blood pressure (BP) of older adults with primary hypertension and postprandial hypotension (PPH). Ninety-six participants were divided into the supine group, the semi-fowler group, and the control group with block-randomization. After a meal, the patients were placed in a supine position, a 45° semi-fowler position, or allowed daily activities, respectively. BP, heart rate and PPH symptoms were measured 5 times in 120 minutes after the meal. Repeated measurement analysis showed no statistical difference in BP, heart rate and PPH symptom scores among the three groups. BP in all groups decreased rapidly at the 30-minute point, and then moved steadily downward. Taking a supine position or semi-fowler position after meals had no effect on postprandial BP and heart rate after meals in older adults with hypertension and PPH.
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Affiliation(s)
- Fengling Lu
- School of Nursing, Beijing University of Chinese Medicine, No.11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China.
| | - Yu Liu
- School of Nursing, Beijing University of Chinese Medicine, No.11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China.
| | - Zhu Xiao
- Department of Cardiology, China-Japan Friendship Hospital, No.2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029 China.
| | - Shishi Wu
- School of Nursing, Beijing University of Chinese Medicine, No.11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China.
| | - Quanying Wu
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No.1 Dongdan Dahua Road, Dongcheng District, Beijing, China.
| | - Keke Lin
- School of Nursing, Beijing University of Chinese Medicine, No.11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China.
| | - Kailian Yang
- Department of Nursing, Zhaoqing Medical College, No.6 Xijiang South Road, Duanzhou District, Zhaoqing, Guangdong, 526020 China.
| | - Xiao Li
- School of Nursing, Beijing University of Chinese Medicine, No.11 Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029 China.
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Wang B, Zhao J, Zhan Q, Wang R, Liu B, Zhou Y, Xu F. Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2021; 8:663635. [PMID: 34095252 PMCID: PMC8172613 DOI: 10.3389/fcvm.2021.663635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Postprandial hypotension (PPH) is an independent predictive factor of all-cause mortality in older people. Drug management has not achieved a satisfactory effect yet. In recent years, many studies have found that acarbose may be effective in the treatment of PPH with glucose metabolism disorders. Objective: To assess the efficacy and safety of acarbose on PPH with glucose metabolism disorders. Methods: PubMed (MEDLINE), Cochrane, EMBASE, Web of Science, Clinical Trials, and relevant Chinese databases were searched from inception to October 1, 2020. Randomized controlled studies of acarbose in the treatment of PPH with glucose metabolism disorders were included. Review Manager 5.3 software was used for quality evaluation and meta-analysis. GRADEpro GDT software was used to GRADE the evidence for the research objectives. Results: A total of 4 randomized controlled studies including 202 participants were identified after screening. The meta-analysis showed that acarbose significantly attenuated the decrease in postprandial systolic blood pressure [weighted mean difference (MD): −9.84, 95% CI: −13.34 to −6.33], diastolic blood pressure (MD: −6.86, 95% CI: −12.89 to −0.83), and mean arterial pressure (MD: −8.10, 95% CI: −12.40 to −3.49) compared with the control group. One study reported a case of adverse reactions that included mild abdominal distension in the acarbose group (4.8%, 1/21). No adverse reactions were reported in the other three studies. Conclusion: Acarbose may attenuate the decrease in postprandial blood pressure and avoid the occurrence of PPH in patients with PPH and abnormal glucose metabolism disorders. More clinical trials are needed to make a clear conclusion. Registration: PROSPERO CRD42020171335.
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Affiliation(s)
- Biqing Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Junnan Zhao
- Institute of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiuxiao Zhan
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rongyanqi Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Birong Liu
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yan Zhou
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Fengqin Xu
- Institute of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Abstract
Hypertension and hypotension are strictly related phenomena, that frequently coexist within the spectrum of cardiovascular autonomic dysfunction, especially at advanced age. Indeed, antihypertensive treatment may predispose to orthostatic and post-prandial hypotension, while intensive blood pressure lowering may be responsible for systemic hypotension. Over recent years, systemic and orthostatic hypotension have emerged as important although often neglected risk factors for adverse outcomes, paralleling the widely recognized arterial hypertension. Both hypertension and hypotension are associated with detrimental effects on target organs and survival, thus significantly impacting patients' prognosis, functional autonomy and quality of life. Balancing low and high blood pressure requires accurate diagnostic assessment of blood pressure values and patients' hypotensive susceptibility, which allow for the development of customized treatment strategies based on individual hypo/hypertensive risk profile. The present review illustrates the complex interrelationship between hypotension and hypertension and discusses the relevant prognostic role of these conditions. Additionally, it provides an overview on hypotension detection and treatment in patients with hypertension, focusing on customized diagnostic and therapeutic strategies.
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Affiliation(s)
- Giulia Rivasi
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, Florence, Italy -
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
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Farrehi C, Pazzi C, Stillman M. A case of postprandial hypotension in an individual with cervical spinal cord injury: treatment with acarbose. Spinal Cord Ser Cases 2019; 5:75. [PMID: 31632733 PMCID: PMC6786392 DOI: 10.1038/s41394-019-0220-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/01/2019] [Accepted: 08/19/2019] [Indexed: 02/03/2023] Open
Abstract
Introduction Postprandial hypotension (PPH) is a postmeal drop in systolic blood pressure that may or may not be symptomatic. While the etiologies of PPH are incompletely understood, it is thought to occur when glucose absorption causes increased splanchnic blood flow or "pooling" in people who lack sufficient compensatory responses to support their systemic blood pressure. Postprandial hypotension is well described in individuals with neurodegenerative diseases, yet only rarely in people living with spinal cord injury (SCI). Acarbose is an alpha-glucosidase inhibitor that treats PPH by slowing gastric transit time and reducing glucose uptake in the small intestine, hence decreasing superior mesenteric artery blood flow. Case presentation A 62-year-old woman with long-standing cervical SCI presented with 5 years of worsening postprandial lightheadedness, visual "flashes", and neck pain. She had had multiple episodes of near and frank syncope and her prior medical team had initiated midodrine three times daily. We began treatment with acarbose, starting at 50 mg with each meal and rapidly titrating to 100 mg at mealtime. She noticed an immediate improvement in her symptoms and an attenuation of postmeal drops in both systolic and diastolic blood pressures. Discussion To our knowledge, this is one of the first described cases of PPH among people living with SCI. Given the autonomic dysfunction that frequently accompanies higher-level of injuries, it is possible that many more people with SCI have this condition, whether or not it is symptomatic. Acarbose is one of the several established treatments for PPH, and proved effective and tolerable for our patient.
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Affiliation(s)
| | | | - Michael Stillman
- Internal Medicine and Rehabilitation Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, 1100 Walnut Street, Suite 601, Philadelphia, PA 19107 USA
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Chisholm P, Anpalahan M. Orthostatic hypotension: pathophysiology, assessment, treatment and the paradox of supine hypertension. Intern Med J 2017; 47:370-379. [PMID: 27389479 DOI: 10.1111/imj.13171] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/12/2016] [Accepted: 06/27/2016] [Indexed: 12/11/2022]
Abstract
Both hypertension and orthostatic hypotension (OH) are strongly age-associated and are common management problems in older people. However, unlike hypertension, management of OH has unique challenges with few well-established treatments. Not infrequently, they both coexist, further compounding the management. This review provides comprehensive information on OH, including pathophysiology, diagnostic workup and treatment, with a view to provide a practical guide to its management. Special references are made to patients with supine hypertension and postprandial hypotension and older hypertensive patients.
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Affiliation(s)
- Peter Chisholm
- Eastern Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mahesan Anpalahan
- Eastern Health, The University of Melbourne, Melbourne, Victoria, Australia.,North West Academic Centre, Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia
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Abstract
Pure autonomic failure (PAF) is a rare sporadic neurodegenerative autonomic disorder characterized by slowly progressive pan autonomic failure without other features of neurologic dysfunctions. The main clinical symptoms result from neurogenic orthostatic hypotension and urinary and gastrointestinal autonomic dysfunctions. Autonomic failure in PAF is caused by neuronal degeneration of pre- and postganglionic sympathetic and parasympathetic neurons in the thoracic spinal cord and paravertebral autonomic ganglia. The presence of Lewy bodies and α-synuclein deposits in these neural structures suggests that PAF is one of Lewy body synucleinopathies, examples of which include multiple system atrophy, Parkinson disease, and Lewy body disease. There is currently no specific treatment to stop progression in PAF. Management of autonomic symptoms is the mainstay of treatment and includes management of orthostatic hypotension and supine hypertension. The prognosis for survival of PAF is better than for the other synucleinopathies.
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Temple JL, Bernard C, Lipshultz SE, Czachor JD, Westphal JA, Mestre MA. The Safety of Ingested Caffeine: A Comprehensive Review. Front Psychiatry 2017; 8:80. [PMID: 28603504 PMCID: PMC5445139 DOI: 10.3389/fpsyt.2017.00080] [Citation(s) in RCA: 266] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/24/2017] [Indexed: 12/12/2022] Open
Abstract
Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research.
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Affiliation(s)
- Jennifer L. Temple
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
| | | | - Steven E. Lipshultz
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Jason D. Czachor
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Joslyn A. Westphal
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Miriam A. Mestre
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
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Nguyen TAN, Abdelhamid YA, Phillips LK, Chapple LS, Horowitz M, Jones KL, Deane AM. Nutrient stimulation of mesenteric blood flow - implications for older critically ill patients. World J Crit Care Med 2017; 6:28-36. [PMID: 28224105 PMCID: PMC5295167 DOI: 10.5492/wjccm.v6.i1.28] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/16/2016] [Accepted: 01/02/2017] [Indexed: 02/06/2023] Open
Abstract
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death. In older critically ill patients, the administration of enteral nutrition acutely increases mesenteric blood flow, but whether this pathophysiological response is protective, or precipitates mesenteric ischaemia, is unknown. There are an increasing number of older patients surviving admission to intensive care units, who are likely to be at increased risk of postprandial hypotension, both during, and after, their stay in hospital. In this review, we describe the prevalence, impact and mechanisms of postprandial hypotension in older people and provide an overview of the impact of postprandial hypotension on feeding prescriptions in older critically ill patients. Finally, we provide evidence that postprandial hypotension is likely to be an unrecognised problem in older survivors of critical illness and discuss potential options for management.
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In Sinn D, Gibbons CH. Pathophysiology and Treatment of Orthostatic Hypotension in Parkinsonian Disorders. Curr Treat Options Neurol 2016; 18:28. [DOI: 10.1007/s11940-016-0410-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Prevalence of and risk factors for postprandial hypotension in older Chinese men. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 12:600-4. [PMID: 26788035 PMCID: PMC4712364 DOI: 10.11909/j.issn.1671-5411.2015.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Objective To assess the prevalence of and risk factors for postprandial hypotension (PPH) among old and very old Chinese men. Methods The study included 349 Chinese men aged 65 and older, grouped into two age categories: group 1 (old) included 163 men aged 65 to 80 years; group 2 (very old) included 186 men aged over 80 years. Blood pressure changes after meals were assessed every 15 min by ambulatory blood pressure monitoring. Symptoms after meal ingestion and after standing up and changes in the baseline condition relative to blood pressure changes were observed continuously. Additional baseline data included body mass index, medical history, and medication use. Results The prevalence of PPH was 59.3% overall and was significantly higher in group 2 than group 1 (63.4% vs. 54.6%, P < 0.05). In group 2, the prevalence of PPH after breakfast (33.8%) and lunch (32.1%) were higher than that after supper (20.9%), P < 0.05. Hypertension and age were significant risk factors for PPH (OR = 2.188, 95% CI: 1.134−4.223, P = 0.02; OR = 1.86, 95% CI: 1.112−3.11, P = 0.018, respectively). In contrast, acarbose use was protective against PPH (OR = 0.4, 95% CI: 0.189−0.847, P = 0.017). The decrease in blood pressure during PPH was 20−40 mmHg and the maximum was 90 mmHg. PPH usually occurred at 30−60 min after a meal and lasted 30−120 min. Conclusions These findings demonstrate that the prevalence of PPH in men aged over 80 years is significantly higher than those in men aged 65 to 80 years, and the blood pressure decline is also higher for men aged over 80 years. In addition, hypertension and age were main risk factors for PPH in the older men, which suggest that preventing and treating PPH is worthwhile.
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Asensio E, Alvarez JB, Lara S, Alvarez de la Cadena JE, Juárez D. Postprandial hypotension in the elderly: Findings in a Mexican population. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2015; 85:284-91. [PMID: 26095051 DOI: 10.1016/j.acmx.2015.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 04/27/2015] [Accepted: 05/08/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Postprandial hypotension is a known cause of syncope in the elderly. Its prevalence is unknown in our country. METHODS A prospective cross-sectional study was performed to determine PPH's Prevalence in elderly adults of both an urban and a rural Community in the State of Queretaro. Blood pressure measurements included a basal pre-prandial record, minute 0 recording at the moment they finished the meal and every 10 min until a 90 min record was complete. We included a medical history, a mental state test for cognitive evaluation (Minimental) and Minnesota Quality of life score and a food macronutrient composition analysis. RESULTS We included 256 subjects, 78.1 ± 8.8 years old, 195 (76.2%) female. Two-hundred and five subjects (80.1%) had Postprandial hypotension after one or both analyzed meals, with non-significant differences in the studied items. Sixty-six (26.2%) patients had "significant postprandial hypotension". Patients living in a special care facility had more postprandial hypotension than people at the family home (87-3% vs 69.8% respectively, p<0.0001). CONCLUSIONS Post-prandial hypotension is a common finding in this elderly population. We did not find distinctive conditions or markers that allow identification of subjects at risk for postprandial hypotension and its complications. This should prompt for routine screenings in specialized facilities to prevent complications.
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Affiliation(s)
- Enrique Asensio
- División de Medicina Interna, Hospital Médica TEC 100, Querétaro, Querétaro, Mexico.
| | - José Benito Alvarez
- Laboratorio de Electrofisiología Clínica, Hospital Español de México, Mexico City, Mexico
| | - Susano Lara
- Hospital de Alta especialidad T1, Instituto Mexicano del Seguro Social, León, Guanajuato, Mexico
| | | | - Daniela Juárez
- Universidad del Valle de México, Campus Querétaro, Querétaro, Mexico
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