Effects of Meal Ingestion and Active Standing on Blood Pressure in Patients ≥60 Years of Age

Imai, Chiharu; Muratani, Hiromi; Kimura, Yorio; Kanzato, Naomi; Takishita, Shuichi; Fukiyama, Koshiro

doi:10.1016/s0002-9149(98)00163-5

Cited by 34 publications

(22 citation statements)

References 19 publications

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“…This compares with reports of 30% in elderly hospital inpatients [2], 7% [11] and 11% [12] in healthy elderly people, and 24 [1], 36 [3] and 69% in elderly nursing home residents [13]. When we examined postprandial hypotension in terms of the magnitude of the fall in SBP, we showed that the SBP dropped by 16 B 21 mm Hg in hostel residents after a meal.…”

Section: Discussionsupporting

confidence: 58%

“…2 Comparison of haemodynamic responses of untreated hypertensive (P) and treated hypertensive subjects ([) to meal, and standing and walking after a meal. * Significant difference between treated and untreated subjects.…”

Section: Prevalence Of Postprandial Hemodynamic Changesmentioning

confidence: 99%

“…Postprandial hypotension, defined by the magnitude of the fall in systolic blood pressure (SBP) after a meal, is common in older people [1][2][3]. While the relationship between syncope and postprandial hypotension has been widely reported [3,4], those studies that have examined linkage to falls have given conflicting results [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Postprandial Systolic Blood Pressure Responses of Older People in Residential Care: Association with Risk of Falling

et al. 2003

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Background: The association between postprandial blood pressure, falls and medications is controversial. Objective: To investigate cardiovascular responses to meals in elderly people together with clinical associations and therapeutic issues. Methods: A cross-sectional observational study of 179 semi-independent older people (age 83.2 ± 7.0 years) in residential care facilities was undertaken. Data on the frequency of falls, medical and medication history and measurement of blood pressure before and after a breakfast meal, and then after standing and walking after the meal were documented. Results: Postprandial hypotension (≧20 mm Hg fall in systolic blood pressure (SBP)) and low absolute SBP (≤115 mm Hg) were common after meals and exacerbated by standing. Risk factors for low postprandial SBP included use of selective serotonin reuptake inhibitors (OR = 4.3, CI 1.4–13.1, p = 0.006), antipsychotic medications (OR = 5.2, CI 1.4–19.2, p = 0.007) and a history of smoking (OR = 4.7, CI 1.5–14.9, p = 0.005). Antihypertensive therapy ameliorated the postprandial decline in blood pressure. The incidence of falls was increased only in the 10% of subjects with low postprandial SBP. Conclusions: Significant adverse cardiovascular change is common after meals in older people and a postprandial SBP of <115 mm Hg was associated with a history of falls. Selective serotonin reuptake inhibitors and antipsychotic medications were associated with low postprandial SBP, which may provide a mechanism for their association with falls. Hypertension was positively and antihypertensive therapy negatively associated with postprandial hypotension.

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Section: Discussionsupporting

confidence: 58%

Section: Prevalence Of Postprandial Hemodynamic Changesmentioning

confidence: 99%

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Postprandial Systolic Blood Pressure Responses of Older People in Residential Care: Association with Risk of Falling

et al. 2003

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“…Various studies have indicated that the pathogenesis of hypotension involves abnormalities in the vascular responsiveness of insulin and catecholamine related to glucose ingestion during meals, 22 disorders in the activation of muscular sympathetic activity, 23,24 and abnormal reactions of cardiac blood vessel-regulating factors, such as vasoactive intestinal peptide (VIP) and somatostatin. 25,26 There have been some reports of postprandial hypotension in the elderly from the viewpoint of sympathetic nervous function.…”

Section: Figmentioning

confidence: 99%

Postprandial hypotension in elderly subjects: spectral analysis of heart rate variability and electrogastrograms

Kawaguchi

Nomura

Miyajima

et al. 2002

Journal of Gastroenterology

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“…It is understandable that associated illnesses may impair these compensatory mechanisms and result in marked postprandial decreases in BP. The exact role of insulin and other vasoactive peptides remains controversial [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Intraindividual Reproducibility of Postprandial Hypotension

Puisieux¹,

Court²,

Baheu³

et al. 2002

Gerontology

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Background: Postprandial hypotension (PPH) is increasingly recognized as a common cause of falls and syncopes in the elderly. The diagnosis of PPH is based on the measurement of meal-induced blood pressure (BP) changes. Although the problem of intraindividual reproducibility of PPH is of clinical importance, it has not been extensively studied. Objective: To assess the intraindividual reproducibility of PPH. Methods: 50 patients (42 women and 8 males, 83 ± 8 years) were included in the study. To evaluate PPH, we measured the BP before and every 15 min for 2 h after the start of a standardized mixed meal. The PPH was defined as a decrease in systolic BP of 20 mm Hg or more. Three sets of BP were obtained for each subject on 2 successive days: (1) between 08.00 and 10.00 h and (2) between 16.00 and 18.00 h on the 1st day and (3) between 08.00 and 10.00 h on the 2nd day. Results: 32 participants (64%) experienced PPH on at least one test. Among them, 19 (38%) had PPH on the first test, 16 (32%) had PPH on the second test, and 21 (42%) had PPH on the third test. The intraindividual reproducibility of PPH was good when the results of the two morning tests were compared together (kappa coefficient = 0.6), but was low when the morning test results were compared with the afternoon test results of the 1st day (kappa coefficient = 0.1). Conclusions: Because of the good reproducibility of postprandial BP changes, we conclude that the diagnosis of PPH may be based on a single standardized test. However, the test must be performed under circumstances (time of the meal, medications) similar to those in which the symptoms occurred.

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Effects of Meal Ingestion and Active Standing on Blood Pressure in Patients ≥60 Years of Age

Cited by 34 publications

References 19 publications

Postprandial Systolic Blood Pressure Responses of Older People in Residential Care: Association with Risk of Falling

Postprandial Systolic Blood Pressure Responses of Older People in Residential Care: Association with Risk of Falling

Postprandial hypotension in elderly subjects: spectral analysis of heart rate variability and electrogastrograms

Intraindividual Reproducibility of Postprandial Hypotension

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