Postprandial hypotension: evaluation by ambulatory blood pressure monitoring☆

Kohara, Katsuhiko; Uemura, K.; Takata, Yasunori; Okura, Takafumi; Kitami, Yutaka; Hiwada, Kunio

doi:10.1016/s0895-7061(98)00161-7

Cited by 40 publications

(42 citation statements)

References 22 publications

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“…Other than these 2 studies, there are several previous reports on a blood pressure reduction by breakfast intake. [23][24][25] This effect of breakfast intake on blood pressure in the morning might be one of the mechanisms of the result from the present study. Because we considered hypertension as a major mediator between breakfast intake and stroke, especially cerebral hemorrhage, we conducted further analyses after stratification by medication use of hypertension.…”

Section: Discussionsupporting

confidence: 52%

Association of Breakfast Intake With Incident Stroke and Coronary Heart Disease

Kubota¹,

Iso²,

Sawada³

et al. 2016

Stroke

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Background and Purpose-The association between breakfast intake and the risk of cardiovascular disease, including stroke, among Asian people remains unknown. We sought to prospectively investigate whether the omission of breakfast is related to increased risks of stroke and coronary heart disease in general Japanese populations. Methods-A total of 82 772 participants (38 676 men and 44 096 women) aged 45 to 74 years without histories of cardiovascular disease or cancer were followed up from 1995 to 2010. Participants were classified as having breakfast 0 to 2, 3 to 4, 5 to 6, or 7 times/wk. The hazard ratios of cardiovascular disease were estimated using Cox proportional hazards models. Results-During the 1 050 030 person-years of follow-up, we documented a total of 4642 incident cases, 3772 strokes (1051 cerebral hemorrhages, 417 subarachnoid hemorrhages, and 2286 cerebral infarctions), and 870 coronary heart disease. Multivariable analysis showed that those consuming no breakfast per week compared with those consuming breakfast everyday had hazard ratios (95% confidence interval; P for trend) of 1.14 (1.01-1.27; 0.013) for total cardiovascular disease, 1.18 (1.04-1.34; 0.007) for total stroke, and 1.36 (1.10-1.70; 0.004) for cerebral hemorrhage. Similar results were observed even after exclusion of early cardiovascular events. No significant association between the frequency of breakfast intake and the risk of coronary heart disease was observed. Conclusions-The frequency of breakfast intake was inversely associated with the risk of stroke, especially cerebral hemorrhage in Japanese, suggesting that eating breakfast everyday may be beneficial for the prevention of stroke. . Of 116 896 subjects, 3053 subjects were excluded from the present study because they were identified as having died, moved out of the study area, or been lost at the second survey. Therefore, a total of 113 393 patients from the 2 cohorts were eligible for participation in the present study, and the second survey was considered as the baseline for this study. Of 113 393 participants, 88 981 participants (78%) completed the questionnaires, including information on breakfast at the second survey. In addition, we excluded 6209 patients who had a history of stroke, myocardial infarction, angina pectoris, or cancer at the baseline. Ultimately, a total of 82 772 participants (38 676 men and 44 096 women) were included in the present study. The institutional human ethics review boards of Osaka University and the National Cancer Center approved the present study. Main Exposure: Frequency of Breakfast IntakeParticipants were asked to provide information concerning the average frequency of breakfast consumption as follows: "How often do you have breakfast a week? Almost never, 1 to 3 times per month, 1 to 2, 3 to 4, 5 to 6 times per week, or everyday." In the current study, subjects were classified into the following 4 groups for comparison: those who had breakfast 0 to 2 (subjects with almost never, those with 1-3 times/mo, and those with 1-2 times/...

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Section: Discussionsupporting

confidence: 52%

Association of Breakfast Intake With Incident Stroke and Coronary Heart Disease

Kubota¹,

Iso²,

Sawada³

et al. 2016

Stroke

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“…Blood pressure (BP) was measured every 30 min from 6:00 AM to 10:00 PM and every 60 min from 10:00 PM to 6:00 AM of the following day (17).…”

Section: Twenty Four-hour Blood Pressure Determinationmentioning

confidence: 99%

Serum Cystatin C Level Is a Marker of End-Organ Damage in Patients with Essential Hypertension

Watanabe

Okura

et al. 2003

Hypertens Res

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High urinary albumin excretion rate (AER) has been associated with the presence of atherosclerotic vascular damages and is an independent risk factor for all causes of death and cardiovascular morbidity and mortality in essential hypertensive patients. Serum cystatin C (s-CC) is a recently identified nonglycosylated 13-kD basic protein that has been suggested to be a useful marker of glomerular filtration rate. In the present study, we investigated the relationship between s-CC level and end-organ damages in the kidney, heart, and

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“…14 However, only a few studies have investigated the effect of PPH on the diurnal change in BP in hypertensive patients. 15,16 In our previous study, 16 we evaluated PPH with ambulatory BP monitoring (ABPM) and showed that PPH contributed to the variability of BP in the daytime and the morning surge of BP, independent of the dipper and nondipper phenomena. Clinically, PPH can cause light-headedness, fainting, falls, or even transient ischemic attack.…”

mentioning

confidence: 99%

Postprandial Hypotension Is Associated With Asymptomatic Cerebrovascular Damage in Essential Hypertensive Patients

et al. 1999

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Abstract-To elucidate the relationship between postprandial hypotension (PPH) and asymptomatic cerebrovascular damage, we evaluated changes in blood pressure after a meal by 24-hour blood pressure monitoring in 70 hospitalized essential hypertensive patients aged Ն50 years. They received a diet containing standard nutritional ingredients with 120 mmol (7 g) NaCl and were free from medication for at least 1 week. PPH was defined as the mean reduction of systolic blood pressure during 2 hours after a meal. Patients were divided into three groups according to mean values of PPH after 3 meals: PPH-1 (nϭ16, 5 mm HgՅPPHϽ10 mm Hg), PPH-2 (nϭ18, PPHՆ10 mm Hg), and normal (nϭ36, PPHϽ5 mm Hg). As asymptomatic cerebrovascular damage, lacunae and leukoaraiosis were evaluated by magnetic resonance imaging. PPH did not correlate with daytime or nighttime blood pressure or the nondipper phenomenon; however, PPH was significantly related to asymptomatic cerebrovascular damage. The prevalence of lacunae in the normal, PPH-1, and PPH-2 groups was 44%, 69%, and 83%, respectively ( 2 ϭ8.22, PϽ0.05). The number of lacunae in the normal, PPH-1, and PPH-2 groups was 1.0Ϯ1.3, 1.3Ϯ1.2, and 1.9Ϯ1.4, respectively (F[2,67]ϭ3.2, PϽ0.05). The prevalence of advanced leukoaraiosis in the normal, PPH-1, and PPH-2 groups was 44%, 50%, and 83%, respectively ( 2 ϭ7.63, PϽ0.05). Severity score of leukoaraiosis in the normal, PPH-1, and PPH-2 groups was 1.5Ϯ0.7, 1.7Ϯ0.8, and 2.1Ϯ0.7, respectively (F [2,67] has been shown to be related to several clinical abnormalities, including advanced end-organ damage, 1-3 secondary hypertension, 4 and autonomic nervous system dysfunction. 5 Several studies have demonstrated a linkage between asymptomatic brain damage and alteration of the diurnal change in BP. 2,6 -8 Recently, it has also been shown that dysregulation of postural change in BP is associated with advanced silent cerebrovascular damage in hypertension in the elderly. 9 Asymptomatic cerebrovascular damage, often found in elderly hypertensive individuals, is associated with cognitive dysfunction, 9 depression of mood, 10 and reduced capacity of the cerebral circulation. 11,12 It has also been shown that patients with asymptomatic lacunae have a significantly higher incidence of future stroke than normal subjects. 13 Postprandial hypotension (PPH) is a relatively common phenomenon frequently observed in elderly hypertensive patients. 14 However, only a few studies have investigated the effect of PPH on the diurnal change in BP in hypertensive patients. 15,16 In our previous study, 16 we evaluated PPH with ambulatory BP monitoring (ABPM) and showed that PPH contributed to the variability of BP in the daytime and the morning surge of BP, independent of the dipper and nondipper phenomena. Clinically, PPH can cause light-headedness, fainting, falls, or even transient ischemic attack. 14 Recently, it has also been shown that PPH is an independent risk factor for future mortality, coronary events, and stroke. 17 These findings suggest the relevance of PPH ...

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Postprandial hypotension: evaluation by ambulatory blood pressure monitoring☆

Cited by 40 publications

References 22 publications

Association of Breakfast Intake With Incident Stroke and Coronary Heart Disease

Association of Breakfast Intake With Incident Stroke and Coronary Heart Disease

Serum Cystatin C Level Is a Marker of End-Organ Damage in Patients with Essential Hypertension

Postprandial Hypotension Is Associated With Asymptomatic Cerebrovascular Damage in Essential Hypertensive Patients

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