Postprandial Hypotension: A Systematic Review

Trahair, Laurence G.; Horowitz, Michael; Jones, Karen L.

doi:10.1016/j.jamda.2014.01.011

Cited by 125 publications

(174 citation statements)

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“…PPH occurs frequently – the prevalence in healthy older individuals is ~25% (Trahair et al. 2014), in residents of aged care facilities 25–40% (Trahair et al. 2014) and in patients with autonomic dysfunction 40–100% (Trahair et al.…”

Section: Introductionmentioning

confidence: 99%

“…2014), in residents of aged care facilities 25–40% (Trahair et al. 2014) and in patients with autonomic dysfunction 40–100% (Trahair et al. 2014).…”

Section: Introductionmentioning

confidence: 99%

“…2014) and in patients with autonomic dysfunction 40–100% (Trahair et al. 2014). Management of symptomatic PPH is suboptimal (Trahair et al.…”

Section: Introductionmentioning

confidence: 99%

“…2014) but, in the broadest sense, a postprandial fall in BP implies that compensatory cardiovascular changes following a meal are inadequate. In healthy young individuals, there are postprandial increases in cardiac output (CO) and heart rate (HR) (Sidery et al.…”

Section: Introductionmentioning

confidence: 99%

“…2014). In particular, gastric emptying (GE), which exhibits a wide interindividual variation (Collins et al.…”

Section: Introductionmentioning

confidence: 99%

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Comparative effects of glucose and water drinks on blood pressure and cardiac function in older subjects with and without postprandial hypotension

et al. 2017

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Postprandial hypotension (PPH) occurs frequently and is thought to reflect an inadequate increase in cardiac output to compensate for the rise in splanchnic blood flow after a meal. Gastric distension by water attenuates the postprandial fall in blood pressure (BP). Cardiac hemodynamics (stroke volume (SV), cardiac output (CO), and global longitudinal strain (GLS)) have hitherto not been measured in PPH. We sought to determine the comparative effects of water and glucose drinks on cardiac hemodynamics in healthy older subjects and individuals with PPH. Eight healthy older subjects (age 71.0 ± 1.7 years) and eight subjects with PPH (age 75.5 ± 1.0 years) consumed a 300 mL drink of either water or 75 g glucose (including 150 mg 13C‐acetate) in randomized order. BP and heart rate (HR) were measured using an automatic device, SV, CO, and GLS by transthoracic echocardiography and gastric emptying by measurement of 13 CO 2. In both groups, glucose decreased systolic BP (P < 0.001) and increased HR, SV, and CO (P < 0.05 for all). The fall in systolic BP was greater (P < 0.05), and increase in HR less (P < 0.05), in the PPH group, with no difference in SV or CO. Water increased systolic BP (P < 0.05) in subjects with PPH and, in both groups, decreased HR (P < 0.05) without affecting SV, CO, or GLS. In subjects with PPH, the hypotensive response to glucose and the pressor response to water were related (R = −0.75, P < 0.05). These observations indicate that, in PPH, the hypotensive response to oral glucose is associated with inadequate compensatory increases in CO and HR, whereas the pressor response to water ingestion is maintained and, possibly, exaggerated.

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Section: Introductionmentioning

confidence: 99%

“…2014), in residents of aged care facilities 25–40% (Trahair et al. 2014) and in patients with autonomic dysfunction 40–100% (Trahair et al. 2014).…”

Section: Introductionmentioning

confidence: 99%

“…2014) and in patients with autonomic dysfunction 40–100% (Trahair et al. 2014). Management of symptomatic PPH is suboptimal (Trahair et al.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…2014). In particular, gastric emptying (GE), which exhibits a wide interindividual variation (Collins et al.…”

Section: Introductionmentioning

confidence: 99%

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