Prevalence and Risk Factors of Postprandial Hypotension among Elderly People Admitted in a Geriatric Evaluation and Management Unit : An Observational Study

Stilmant, Didier; Iacovelli, M.; Toussaint, E; Sibille, François-Xavier; Saint-Hubert, Marie de; Cremer, G

doi:10.1007/s12603-019-1271-1

Cited by 9 publications

(15 citation statements)

References 34 publications

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“…Possible mechanisms of acarbose to improve PPH include inhibition of postprandial splanchnic perfusion, which reduces high-risk disease in the elderly, which is related to age. The prevalence of PPH in elderly inpatients can reach 46% ( 1 , 23 ). The clinical non-drug management of PPH mainly includes eating more meals a day but less food at each, drinking water before meals, postprandial exercise, etc.…”

Section: Discussionmentioning

confidence: 99%

Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis

Wang

Zhao

Zhan

et al. 2021

Front. Cardiovasc. Med.

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Background: Postprandial hypotension (PPH) is an independent predictive factor of all-cause mortality in older people. Drug management has not achieved a satisfactory effect yet. In recent years, many studies have found that acarbose may be effective in the treatment of PPH with glucose metabolism disorders.Objective: To assess the efficacy and safety of acarbose on PPH with glucose metabolism disorders.Methods: PubMed (MEDLINE), Cochrane, EMBASE, Web of Science, Clinical Trials, and relevant Chinese databases were searched from inception to October 1, 2020. Randomized controlled studies of acarbose in the treatment of PPH with glucose metabolism disorders were included. Review Manager 5.3 software was used for quality evaluation and meta-analysis. GRADEpro GDT software was used to GRADE the evidence for the research objectives.Results: A total of 4 randomized controlled studies including 202 participants were identified after screening. The meta-analysis showed that acarbose significantly attenuated the decrease in postprandial systolic blood pressure [weighted mean difference (MD): −9.84, 95% CI: −13.34 to −6.33], diastolic blood pressure (MD: −6.86, 95% CI: −12.89 to −0.83), and mean arterial pressure (MD: −8.10, 95% CI: −12.40 to −3.49) compared with the control group. One study reported a case of adverse reactions that included mild abdominal distension in the acarbose group (4.8%, 1/21). No adverse reactions were reported in the other three studies.Conclusion: Acarbose may attenuate the decrease in postprandial blood pressure and avoid the occurrence of PPH in patients with PPH and abnormal glucose metabolism disorders. More clinical trials are needed to make a clear conclusion.Registration: PROSPERO CRD42020171335.

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Section: Discussionmentioning

confidence: 99%

Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis

Wang

Zhao

Zhan

et al. 2021

Front. Cardiovasc. Med.

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“…The included studies were conducted in the following countries: South Korea [ 23 , 24 ], France [ 25 , 26 ], Australia [ 27 , 28 ], Japan [ 9 , 29 ], the USA [ 30 , 31 ], Belgium [ 10 ], Mexico [ 11 ] and the Netherlands [ 14 ]. Papers were published between 1991 and 2020.…”

Section: Resultsmentioning

confidence: 99%

“…Nine and four studies used cross-sectional and cohort design, respectively ( Table 1 ). Participants were enlisted from diverse settings: three studies recruited participants from communities [ 9 , 23 , 27 ]; four from long-term healthcare facilities [ 24 , 28 , 30 , 31 ]; five from hospitals, specifically from an acute geriatric department [ 10 ], geriatric rehabilitation centre [ 25 ] and geriatric department [ 14 , 26 , 29 ]; and the remaining from retirement homes and communities [ 11 ]. The inclusion and exclusion criteria varied across the included studies [ 9–11 , 14 , 23–31 ], and the sample sizes fluctuated between 50 and 1,308 cases.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of postprandial hypotension in older adults: a systematic review and meta-analysis

Huang,

Li,

Xie

et al. 2024

Age and Ageing

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Background Older adults with postprandial hypotension (PPH) increase susceptibility to falls, syncope, stroke, acute cardiovascular diseases and even death. However, the prevalence of this condition varies significantly across studies. We aimed to determine the prevalence of PPH in older adults. Methods Web of Science, PubMed, Cochrane Library, Embase and CINAHL were searched from their inception until February 2023. Search terms included ‘postprandial period’, ‘hypotension’ and ‘postprandial hypotension’. Eligible studies were assessed using the Joanna Briggs Institute tool. Meta-analyses were performed among similar selected studies. Results Thirteen eligible studies were included, and data from 3,021 participants were pooled. The meta-analysis revealed a PPH prevalence of 40.5% [95% confidence interval (CI): 0.290–0.519] in older adults, and this was prevalent in the community (32.8%, 95% CI: 0.078–0.647, n = 1,594), long-term healthcare facility (39.4%, 95% CI: 0.254–0.610, n = 1,062) and geriatrics department of hospitals (49.3%, 95% CI: 0.357–0.630, n = 365). The pooled results showed significant heterogeneity (I2 > 90%), partially related to the different ages, sex, pre-prandial systolic blood pressure levels of participants, or the different criteria and methodology used to diagnose PPH. Conclusions PPH is a prevalent condition in older adults. Further research is needed to confirm this result, and priority should be given to establishing international consensus on PPH diagnostic criteria and designing its diagnostic procedure.

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“…This scoping review included only older adults with PPH, while those without PPH who showed a slight decrease in postprandial SBP were excluded. Previous studies reported that the maximal reduction in postprandial SBP in older adults with PPH, ranging from 46 to 56 mmHg, was significantly greater than that in the no‐PPH group (<20 mmHg; Madden et al, 2021; Schoevaerdts et al, 2019). In identifying the scope of the studies available regarding this topic and research gaps, older adults were defined as the mean or median age of participants aged 60 years or older.…”

Section: Methodsmentioning

confidence: 92%

“…Postprandial hypotension (PPH), a common disease in older adults with a prevalence rate of 35%–58% (Schoevaerdts et al, 2019), is usually defined as a reduction in postprandial systolic blood pressure (SBP) of >20 mmHg relative to pre‐prandial SBP within the first 2 h after the start of a meal (Jenkins et al, 2022). Although its pathophysiology remains unclear, PPH is known to involve an interplay between autonomic and neural mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Non‐pharmacological interventions for older adults with postprandial hypotension: A scoping review

Huang

Liu

Xie

et al. 2023

Journal of Clinical Nursing

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BackgroundOlder adults frequently suffer from postprandial hypotension, associated with an increased risk of falls, syncope, acute cardiovascular and cerebrovascular diseases, and even death. Researchers use non‐pharmacological interventions, but related literature is dispersed and lacks a latest summary.ObjectiveThe aim of this study was to map and examine non‐pharmacological interventions currently employed to assist older adults with postprandial hypotension and lay a solid foundation for future studies.MethodsThis study adhered to the JBI methodology for scoping reviews and preferred reporting items for systematic reviews and meta‐analyses extension for scoping reviews. PubMed, Web of Science, Embase, Cochrane Library, CINAHL, SCOPUS, Chinese Biomedical Journal, China National Knowledge Infrastructure, VIP and WAN FANG Data were retrieved from their inception to 1 August 2022.ResultsTwo randomized controlled trials and seven quasi‐experimental studies were included. Small meals, exercise interventions, fibre with meals, green tea and water therapy have been reported to prevent postprandial hypotension effectively; however, position changes have been reported to have no impact on postprandial blood pressure decrease. Additionally, the blood pressure determination methods and test meals may affect observed trial effects.ConclusionLarge samples and long‐term follow‐up studies are needed to prove the efficacy and safety of existing non‐pharmacological interventions. Future studies should develop a BP determination method based on the postprandial BP decline trajectory induced by a given test meal to improve the reliability of study results.Relevance to Clinical PracticeThis review broadly summarizes existing studies on developing and validating non‐pharmacological interventions for older adults with postprandial hypotension. It also analyses special factors that may influence the trial effects. This may provide a useful reference for future research.

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Prevalence and Risk Factors of Postprandial Hypotension among Elderly People Admitted in a Geriatric Evaluation and Management Unit : An Observational Study

Cited by 9 publications

References 34 publications

Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis

Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis

Prevalence of postprandial hypotension in older adults: a systematic review and meta-analysis

Non‐pharmacological interventions for older adults with postprandial hypotension: A scoping review

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