Postprandial Blood Pressure Reduction in Healthy Elderly

Abstract

Previous studies have identified postprandial systolic blood pressure reductions in old, frail institutionalized subjects, which do not occur in healthy, young subjects, after a morning meal. To evaluate the relative contributions of state of health and time of day to this potentially dangerous abnormality in cardiovascular homeostasis, we measured sitting systolic blood pressure and heart rate before and at intervals after a noon meal, and in identical fashion without a meal, in 21 healthy, community-dwelling elderly subjects (73 +/- 6 years of age) attending a nutrition program. Systolic blood pressure changed a maximum of -11 +/- 9 (SD) mmHg (P = .006, analysis of variance) by 60 minutes after the meal, in contrast to 1 +/- 7 mmHg (NS) by 60 minutes, when no meal was given (P less than .0001, meal versus control studies). There was a highly significant inverse correlation between postprandial and basal sitting systolic blood pressure changes (R = -0.60, P = .004). Healthy community-dwelling elderly demonstrate postprandial reductions in systolic blood pressure which correlate with basal sitting systolic blood pressure. This is consistent with age- and hypertension-related impairment in baroreflex compensation for the hypotensive stress of eating.

Effect of temazepam on blood pressure regulation in healthy elderly subjects.

“…Temazepam reduced systolic but not diastolic blood pressure on standing, as contrasted with the effects of the meal which were on both systolic and diastolic blood pressure. The postprandial fall in blood pressure and increase in heart rate have been described previously in elderly subjects (Lipsitz & Fullerton, 1986). This study was not designed to assess whether temazepam would influence postprandial changes in blood pressure and heart rate.…”

Influence of meal intake on pulse wave indices in type 2 diabetes

“…On the other hand, postprandial hypotension has been observed in elderly patients with advanced atherosclerosis 24,36,37 and in patients with autonomic neuropathy, 24,38,39 which are frequently seen among patients with diabetes. Unfortunately, we did not assess autonomic function such as heart rate variability.…”

Guidelines on management (diagnosis and treatment) of syncope

“…Events due to orthostatic hypotension usually occur in the morning [372] . The history should include any association with meals (post-prandial) [372,386] , ingestion of medications, nocturnal micturition [378] , etc. One-third of over-65-year-olds are taking three or more prescribed medications.…”