Abstract
Over the past two decades, postprandial hypotension (PPH) has become recognized as a common problem among elderly people and patients with autonomic insufficiency, Parkinson’s Disease, diabetes mellitus, and renal failure [1]. Defined as a 20 mmHg or greater decline in systolic blood pressure within 2 h of the start of a meal, PPH has been reported to occur in 24% [2] to 36% [3] of nursing-home residents, and in 23% of elderly persons admitted to a geriatric hospital with syncope or falls [4]. Meal-related hypotension is particularly common among elderly people with hypertension and is more prevalent than orthostatic hypotension in the elderly population.
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References
Jansen RWMM, Lipsitz LA (1995) Postprandial hypotension: epidemiology, pathophysiology, and clinical management. Ann Intern Med 122:286–295
Aronow WS, Ahn C (1994) Postprandial hypotension in 499 elderly persons in a long-term health care facility. J Amer Geriatr Soc 42:930
Vaitkevicius PV, Esserwein DM, Maynard AK et al (1991) Frequency and importance of postprandial blood pressure reduction in elderly nursing-home patients. Ann Intern Med 115:865
Puisieux F, Bulckaen, Fauchais AL et al (2000) Ambulatory blood pressure monitoring and postprandial hypotension in elderly persons with falls or syncope. J Gerontol 55A:M535
Lipsitz LA, Pluchino FC, Wei JY, Rowe JW (1986) Syncope in institutionalized elderly: the impact of multiple pathological conditions and situational stress. J Chron Dis 39:619
Jansen RWMM, Connelly CM, Kelley-Gagnon MM et al (1995) Postprandial hypotension in elderly patients with unexplained syncope. Arch Int Med 155:945–952
Kamata T, Yokota T, Jurukawa T, Tsukagoshi H (1994) Cerebral ischemic attack caused by postprandial hypotension. Stroke 25:511–513
Kohara K, Jiang Y, Igase M et al (1999) Postprandial hypotension is associated with asymptomatic cerebrovascular damage in essential hypertensive patients. Hypertension 33:565–568
Krajewski A, Freeman R, Ruthazer R et al (1993) Transcranial Doppler assessment of the cerebral circulation during postprandial hypotension in the elderly. J Amer Geriatr Soc 41:19–24
Kooner JS, Raimbach S, Watson L et al (1989) Relationship between splanchnic vasodilation and postprandial hypotension in patients with primary autonomic failure. J Hypertension 7[Suppl 6]:S40
Kearney MT, Cowley AJ, Stubbs TA et al (1988) Depressor action of insulin on skeletal muscle vasculature: a novel mechanism for postprandial hypotension in the elderly. J Am Coll Cardiol 31:209
Lipsitz LA, Ryan SM, Parker JA et al (1993) Hemodynamic and autonomic nervous system responses to mixed meal ingestion in healthy young and old subjects and dysautonomic patients with postprandial hypotension. Circulation 87:391
Oberman AS, Gagnon MM, Kiely DK et al (2000) Autonomic and neurohumoral control of postprandial blood pressure in healthy aging. J Gerontol 55 A:M477–M483
Lipsitz LA, Pluchino FC, Wei JW et al (1986) Cardiovascular and norepinephrine responses after meal consumption in elderly (older than 75 years) persons with postprandial hypotension and syncope. Am J Cardiol 58:810
Jansen RWMM, Penterman JM, van Lier HJJ, Hoefnagels WHL (1987) Blood pressure reduction after oral glucose loading and its relation to age, blood pressure and insulin. Am J Cardiol 60:1087
Sidery MB, Cowley AJ, MacDonald IA (1993) Cardiovascular responses to a high-fat and a high-carbohydrate meal in healthy elderly subjects. Clin Sci 84:263
Fagius J, Berne C (1994) Increase in muscle nerve sympathetic activity in humans after food intake. Clin Sci 86:159
Hakusui S, Sugiyama Y, Iwase S et al (1991) Postprandial hypotension: microneuro-graphic analysis and treatment with vasopressin. Neurology 41:712
Fagius J, Ellerfelt K, Lithell H, Berne C (1996) Increase in muscle nerve sympathetic activity after glucose intake is blunted in the elderly. Clin Autonom Res 6:195
Hogikyan RV, Supiano MA (1994) Arterial α-adrenergic responsiveness is decreased and SNS activity is increased in older humans. Am J Physiol 266:E717–E724
Van Kraaij DJW, Jansen RWMM, Bouwels LHR, Hoefnagels WHL (1999) Furosemide withdrawal improves postprandial hypotension in elderly patients with heart failure and preserved left ventricular systolic function. Arch Int Med 159:1599
Potter JF, Heseltine D, Hartley G (1989) Effects of meal composition on the postprandial blood pressure, catecholamine and insulin changes in elderly subjects. Clin Sci 77:265–272
Jansen RWMM, Peeters TL, van Lier HJJ, Hoefnagels WHL (1990) The effect of oral glucose, protein, fat and water loading on blood pressure and the gastrointestinal peptides VIPO and somatostatin in hypertensive elderly subjects. Eur J Clin Invest 20:192
Kuipers HMM, Jansen RWMM, Peeters TL, Hoefnagels WHL (1991) The influence of food temperature on postprandial blood pressure reduction and its relation to sub-stance-P in healthy elderly subjects. JAGS 38:181
Oberman AS, Harada RK, Gagnon MM et al (1999) Effects of postprandial walking exercise on meal-related hypotension in frail elderly patients. Am J Cardiol 84:1130–1132
Freeman R, Young J, Landsberg L, Lipsitz L (1996) The treatment of postprandial hypotension in autonomic failure with 3,4-DL-threo-dihydroxyphenylserine. Neurology 47:1414–1417
Jones KL, Macintosh C, Su Y-C et al (2001) Guar gum reduces postprandial hypotension in older people. JAGS 49:162–167
Jansen RWMM, van Lier HJJ, Hoefnagels WHL (1988) Effects of nitrendipine and hydrochlorothiazide on postprandial blood pressure reduction and carbohydrate metabolism in hypertensive patients over 70 years of age. J Cardiol Pharmacol 12[Suppl4]:S59–S63
Connelly CM, Waksmonski C, Gagnon MM, Lipsitz LA (1995) Effects of isosorbide dinitrate and nicardipine hydrochloride on postprandial blood pressure in elderly patients with stable angina pectoris or healed myocardial infarction. Am J Cardiol 75:291–293
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Lipsitz, L.A. (2002). Postprandial Hypotension: Pathophysiology and Management. In: Raviele, A. (eds) Cardiac Arrhythmias 2001. Springer, Milano. https://doi.org/10.1007/978-88-470-2103-7_4
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DOI: https://doi.org/10.1007/978-88-470-2103-7_4
Publisher Name: Springer, Milano
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