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Ambulatory blood pressure monitoring and postprandial hypotension in elderly persons with falls or syncopes.
J Gerontol A Biol Sci Med Sci. 2000 Sep; 55(9):M535-40.JG

Abstract

BACKGROUND

Postprandial hypotension (PPH) is increasingly recognized as a common cause of falls and syncope in elderly persons. Noninvasive ambulatory blood pressure monitoring (ABPM) has been recommended for detecting PPH. This study investigates postprandial blood pressure (BP) changes by means of ABPM in elderly patients experiencing falls or syncopes.

METHODS

Twenty-four-hour ABPM was performed in 156 inpatients (111 women, mean age 80.4 +/- 8.1 years). Among them, 45 had been admitted for falls and 75 for syncope; 36 with no history of falls or syncope served as controls. Postprandial change in systolic blood pressure (deltaSBP) was calculated by subtracting the mean SBP within the 2 hours following the meal from the mean SBP within the 2 hours preceding the meal. PPH was defined by a deltaSBP > or = 20 mm Hg.

RESULTS

For the entire group, mean SBP decreased after the three meals. On average, the decline in SBP was greater after breakfast than after lunch or dinner, and the number of patients experiencing PPH was greater after breakfast. Average maximal deltaSBP was significantly larger in the syncope group than in the other groups (p < .05). Moreover, the number of patients experiencing PPH was significantly higher in the syncope/fall group than in the control group (23% vs 9%; p = .03). Compared with patients without PPH, patients with PPH were more likely to have a history of diabetes mellitus (p < .01) or to use more than three different drugs daily (p = .04), and they showed greater daytime SBP variability (p < .0001). Furthermore, there was a strong positive correlation between preprandial SBP and deltaSBP after breakfast.

CONCLUSIONS

About one out of four elderly patients with falls or syncope experiences PPH, usually after breakfast. Postprandial decline in BP contributes to BP variability. deltaSBP and preprandial SBP are positively correlated.

Authors+Show Affiliations

Department of Internal Medicine and Geriatrics, Hôpital Gériatrique les Bateliers, Centre Hospitalier Régional, and University of Lille, France. fpuisieux@nordnet.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10995052

Citation

Puisieux, F, et al. "Ambulatory Blood Pressure Monitoring and Postprandial Hypotension in Elderly Persons With Falls or Syncopes." The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 55, no. 9, 2000, pp. M535-40.
Puisieux F, Bulckaen H, Fauchais AL, et al. Ambulatory blood pressure monitoring and postprandial hypotension in elderly persons with falls or syncopes. J Gerontol A Biol Sci Med Sci. 2000;55(9):M535-40.
Puisieux, F., Bulckaen, H., Fauchais, A. L., Drumez, S., Salomez-Granier, F., & Dewailly, P. (2000). Ambulatory blood pressure monitoring and postprandial hypotension in elderly persons with falls or syncopes. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 55(9), M535-40.
Puisieux F, et al. Ambulatory Blood Pressure Monitoring and Postprandial Hypotension in Elderly Persons With Falls or Syncopes. J Gerontol A Biol Sci Med Sci. 2000;55(9):M535-40. PubMed PMID: 10995052.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ambulatory blood pressure monitoring and postprandial hypotension in elderly persons with falls or syncopes. AU - Puisieux,F, AU - Bulckaen,H, AU - Fauchais,A L, AU - Drumez,S, AU - Salomez-Granier,F, AU - Dewailly,P, PY - 2000/9/20/pubmed PY - 2000/10/14/medline PY - 2000/9/20/entrez SP - M535 EP - 40 JF - The journals of gerontology. Series A, Biological sciences and medical sciences JO - J Gerontol A Biol Sci Med Sci VL - 55 IS - 9 N2 - BACKGROUND: Postprandial hypotension (PPH) is increasingly recognized as a common cause of falls and syncope in elderly persons. Noninvasive ambulatory blood pressure monitoring (ABPM) has been recommended for detecting PPH. This study investigates postprandial blood pressure (BP) changes by means of ABPM in elderly patients experiencing falls or syncopes. METHODS: Twenty-four-hour ABPM was performed in 156 inpatients (111 women, mean age 80.4 +/- 8.1 years). Among them, 45 had been admitted for falls and 75 for syncope; 36 with no history of falls or syncope served as controls. Postprandial change in systolic blood pressure (deltaSBP) was calculated by subtracting the mean SBP within the 2 hours following the meal from the mean SBP within the 2 hours preceding the meal. PPH was defined by a deltaSBP > or = 20 mm Hg. RESULTS: For the entire group, mean SBP decreased after the three meals. On average, the decline in SBP was greater after breakfast than after lunch or dinner, and the number of patients experiencing PPH was greater after breakfast. Average maximal deltaSBP was significantly larger in the syncope group than in the other groups (p < .05). Moreover, the number of patients experiencing PPH was significantly higher in the syncope/fall group than in the control group (23% vs 9%; p = .03). Compared with patients without PPH, patients with PPH were more likely to have a history of diabetes mellitus (p < .01) or to use more than three different drugs daily (p = .04), and they showed greater daytime SBP variability (p < .0001). Furthermore, there was a strong positive correlation between preprandial SBP and deltaSBP after breakfast. CONCLUSIONS: About one out of four elderly patients with falls or syncope experiences PPH, usually after breakfast. Postprandial decline in BP contributes to BP variability. deltaSBP and preprandial SBP are positively correlated. SN - 1079-5006 UR - https://www.unboundmedicine.com/medline/citation/10995052/Ambulatory_blood_pressure_monitoring_and_postprandial_hypotension_in_elderly_persons_with_falls_or_syncopes_ L2 - https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/55.9.m535 DB - PRIME DP - Unbound Medicine ER -