Postprandial hypotension in elderly patients with unexplained syncope

Abstract

Backgrounds Syncope in older patients may be caused by a variety of disorders, including hypotension, but fre quently remains unexplained. Postprandial hypoten sion is a common disorder of blood pressure regulation in the elderly.

Association of Postprandial Hypotension With Incidence of Falls, Syncope, Coronary Events, Stroke, and Total Mortality at 29‐Month Follow‐Up in 499 Older Nursing Home Residents

“…Marked reductions in postprandial systolic blood pressure in older people may predispose tham to symptomatic hypotension and to have falls, syncope, angina pectoris, and transient cerebral ischemic attacks 1–11 . The data from the present prospective study showed at 29‐month mean follow‐up that a marked reduction in postprandial systolic blood pressure was associated with an earlier incidence of falls, syncope, new coronary events, new stroke, and total mortality in older nursing home residents.…”

“…Postprandial reductions in systolic blood pressure in older people may predispose them to symptomatic hypotension and to syncope or falls 1–10 . Jansen et al 10 found that 50% of older persons with unexplained syncope occurring within 2 hours of a meal had postprandial hypotension. Impairment of perfusion in different vascular beds may cause angina pectoris 2 or a transient cerebral ischemic attack 2,11 .…”

Postprandial hypotension in older Australians: Relationship to glycaemia and habitual food intake

“…In healthy people, haemodynamic changes following a meal result in increases in HR, cardiac output and peripheral vascular resistance to compensate for splanchnic blood pooling, and to prevent a significant decline in BP. 22 Group 0 did not show a significant rise in HR over the postprandial period, whereas group 1 did (Table 2). Overall, these effects were significantly different between the two groups ( Table 2).…”

Postprandial Hypotension in Clinical Geriatric Patients and Healthy Elderly: Prevalence Related to Patient Selection and Diagnostic Criteria

“…Potential symptoms of a fall in blood pressure include dizziness, syncope, and falls. It has been described frequently in elderly individuals, with a higher incidence in certain risk groups, namely, in 24%–33% of elderly residents of nursing homes [3], in almost 50% of elderly patients with unexplained syncope [4] and in 67% of hospitalized geriatric patients [5]. Risk groups are patients with autonomic dysfunction in diabetes mellitus [6], hypertension [7, 8], Alzheimer's disease [9] and Parkinson's disease [10, 11] although PPH has been reported to occur in 33% of healthy individuals [12].…”