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Upright posture and postprandial hypotension in elderly persons.
Ann Intern Med. 2000 Oct 03; 133(7):533-6.AIM

Abstract

BACKGROUND

Syncope and falls are common in elderly persons and often result from the interaction of multiple clinical abnormalities. Both orthostatic hypotension and postprandial hypotension increase in prevalence with age.

OBJECTIVE

To determine whether meal ingestion enhances orthostatic hypotension in elderly persons.

DESIGN

Controlled paired comparison.

SETTING

Clinical research center.

PATIENTS

50 functionally independent elderly persons recruited from local senior centers (n = 47) and from patients hospitalized with an unexplained fall or syncope (n = 3) (mean age, 78 years [range, 61 to 96 years]). Twenty-five participants (50%) were taking antihypertensive medication.

MEASUREMENTS

Sequential head-up tilt-table testing at 60 degrees was performed before and 30 minutes after ingestion of a standardized warm liquid meal that was high in carbohydrates. Heart rate and blood pressure were continuously monitored.

RESULTS

Meal ingestion (P < 0.01) and time spent upright (P < 0.001) were significantly associated with systolic blood pressure, but no significant interaction was found between meal ingestion and time spent upright (P > 0.2). These findings suggest that the association between meal ingestion and head-up tilt-table testing were additive and not synergistic. However, the proportion of participants with symptomatic hypotension increased during head-up tilt-table testing after meal ingestion (12% during preprandial testing and 22% during postprandial testing). Symptomatic hypotension tended to occur more often and sooner after meal ingestion than before meal ingestion (P = 0.03).

CONCLUSIONS

Meal ingestion and head-up tilt-table testing are associated with increasing occurrences of symptomatic hypotension. After meal ingestion and head-up tilt-table testing, 22% of functionally independent elderly persons had symptomatic hypotension.

Authors+Show Affiliations

Division of Circulatory Physiology, College of Physicians and Surgeons, Columbia University, 177 Fort Washington Avenue, MHB 5-435, New York, NY 10032, USA. msm10@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11015166

Citation

Maurer, M S., et al. "Upright Posture and Postprandial Hypotension in Elderly Persons." Annals of Internal Medicine, vol. 133, no. 7, 2000, pp. 533-6.
Maurer MS, Karmally W, Rivadeneira H, et al. Upright posture and postprandial hypotension in elderly persons. Ann Intern Med. 2000;133(7):533-6.
Maurer, M. S., Karmally, W., Rivadeneira, H., Parides, M. K., & Bloomfield, D. M. (2000). Upright posture and postprandial hypotension in elderly persons. Annals of Internal Medicine, 133(7), 533-6.
Maurer MS, et al. Upright Posture and Postprandial Hypotension in Elderly Persons. Ann Intern Med. 2000 Oct 3;133(7):533-6. PubMed PMID: 11015166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Upright posture and postprandial hypotension in elderly persons. AU - Maurer,M S, AU - Karmally,W, AU - Rivadeneira,H, AU - Parides,M K, AU - Bloomfield,D M, PY - 2000/10/3/pubmed PY - 2000/10/7/medline PY - 2000/10/3/entrez SP - 533 EP - 6 JF - Annals of internal medicine JO - Ann Intern Med VL - 133 IS - 7 N2 - BACKGROUND: Syncope and falls are common in elderly persons and often result from the interaction of multiple clinical abnormalities. Both orthostatic hypotension and postprandial hypotension increase in prevalence with age. OBJECTIVE: To determine whether meal ingestion enhances orthostatic hypotension in elderly persons. DESIGN: Controlled paired comparison. SETTING: Clinical research center. PATIENTS: 50 functionally independent elderly persons recruited from local senior centers (n = 47) and from patients hospitalized with an unexplained fall or syncope (n = 3) (mean age, 78 years [range, 61 to 96 years]). Twenty-five participants (50%) were taking antihypertensive medication. MEASUREMENTS: Sequential head-up tilt-table testing at 60 degrees was performed before and 30 minutes after ingestion of a standardized warm liquid meal that was high in carbohydrates. Heart rate and blood pressure were continuously monitored. RESULTS: Meal ingestion (P < 0.01) and time spent upright (P < 0.001) were significantly associated with systolic blood pressure, but no significant interaction was found between meal ingestion and time spent upright (P > 0.2). These findings suggest that the association between meal ingestion and head-up tilt-table testing were additive and not synergistic. However, the proportion of participants with symptomatic hypotension increased during head-up tilt-table testing after meal ingestion (12% during preprandial testing and 22% during postprandial testing). Symptomatic hypotension tended to occur more often and sooner after meal ingestion than before meal ingestion (P = 0.03). CONCLUSIONS: Meal ingestion and head-up tilt-table testing are associated with increasing occurrences of symptomatic hypotension. After meal ingestion and head-up tilt-table testing, 22% of functionally independent elderly persons had symptomatic hypotension. SN - 0003-4819 UR - https://www.unboundmedicine.com/medline/citation/11015166/Upright_posture_and_postprandial_hypotension_in_elderly_persons_ L2 - https://www.acpjournals.org/doi/10.7326/0003-4819-133-7-200010030-00012?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -