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A randomized, crossover study of the acute effects of acarbose and gastric distension, alone and combined, on postprandial blood pressure in healthy older adults.
BMC Geriatr. 2019 08 30; 19(1):241.BG

Abstract

BACKGROUND

Postprandial hypotension (PPH) occurs frequently in the elderly and patients with type 2 diabetes, and lacks a satisfactory treatment. Gastric distension and the α-glucosidase inhibitor, acarbose, may attenuate the postprandial fall in blood pressure (BP) by complementary mechanisms. We aimed to determine whether gastric distension and acarbose have additive effects to attenuate the fall in BP induced by oral sucrose.

METHODS

Ten healthy older adults (74.0 ± 1.4 yr) had measurements of BP and superior mesenteric artery (SMA) blood flow for 120 min after receiving either (i) the 'study drink' of 100 g sucrose in 300 mL of water (control treatment), (ii) a 300 mL water 'preload' 15 min before the 'study drink' (distension treatment), (iii) 100 mg acarbose dissolved in the 'study drink' (acarbose treatment) or (iv) a 300 ml water 'preload' 15 min before 100 mg acarbose dissolved in the 'study drink' (acarbose and distension treatment).

RESULTS

The area under the curve (AUC)0-120min for mean arterial pressure (MAP) was greater (P = 0.005) and the maximum fall in MAP was less (P = 0.006) during treatments with acarbose. Gastric distension did not affect the MAP-AUC0-120min response to acarbose (P = 0.44) and there was no effect of gastric distension alone (P = 0.68). Both acarbose treatments attenuated the rise in SMA blood flow (P = 0.003), whereas gastric distension had no effect.

CONCLUSIONS

In healthy older adults, acarbose (100 mg), but not gastric distension, attenuates the fall in BP and rise in SMA blood flow after oral sucrose. The observations support the use of acarbose, but not gastric distension, to attenuate a postprandial fall in BP.

TRIAL REGISTRATION

The study was retrospectively registered at (ACTRN12618000152224) on February 02nd 2018.

Authors+Show Affiliations

NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Level 5 Adelaide Health and Medical Sciences Building, Cnr North Tce and George St, Adelaide, SA, 5005, Australia.NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Level 5 Adelaide Health and Medical Sciences Building, Cnr North Tce and George St, Adelaide, SA, 5005, Australia.NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Level 5 Adelaide Health and Medical Sciences Building, Cnr North Tce and George St, Adelaide, SA, 5005, Australia. Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia.NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Level 5 Adelaide Health and Medical Sciences Building, Cnr North Tce and George St, Adelaide, SA, 5005, Australia. Gastroenterology and Hepatology Unit, Royal Adelaide Hospital, Adelaide, Australia.NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Level 5 Adelaide Health and Medical Sciences Building, Cnr North Tce and George St, Adelaide, SA, 5005, Australia. Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia.NHMRC Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, Level 5 Adelaide Health and Medical Sciences Building, Cnr North Tce and George St, Adelaide, SA, 5005, Australia. karen.jones@adelaide.edu.au. Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia. karen.jones@adelaide.edu.au.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31470806

Citation

Pham, Hung, et al. "A Randomized, Crossover Study of the Acute Effects of Acarbose and Gastric Distension, Alone and Combined, On Postprandial Blood Pressure in Healthy Older Adults." BMC Geriatrics, vol. 19, no. 1, 2019, p. 241.
Pham H, Trahair L, Phillips L, et al. A randomized, crossover study of the acute effects of acarbose and gastric distension, alone and combined, on postprandial blood pressure in healthy older adults. BMC Geriatr. 2019;19(1):241.
Pham, H., Trahair, L., Phillips, L., Rayner, C., Horowitz, M., & Jones, K. (2019). A randomized, crossover study of the acute effects of acarbose and gastric distension, alone and combined, on postprandial blood pressure in healthy older adults. BMC Geriatrics, 19(1), 241. https://doi.org/10.1186/s12877-019-1251-7
Pham H, et al. A Randomized, Crossover Study of the Acute Effects of Acarbose and Gastric Distension, Alone and Combined, On Postprandial Blood Pressure in Healthy Older Adults. BMC Geriatr. 2019 08 30;19(1):241. PubMed PMID: 31470806.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized, crossover study of the acute effects of acarbose and gastric distension, alone and combined, on postprandial blood pressure in healthy older adults. AU - Pham,Hung, AU - Trahair,Laurence, AU - Phillips,Liza, AU - Rayner,Christopher, AU - Horowitz,Michael, AU - Jones,Karen, Y1 - 2019/08/30/ PY - 2019/02/20/received PY - 2019/08/18/accepted PY - 2019/9/1/entrez PY - 2019/9/1/pubmed PY - 2020/6/10/medline KW - Acarbose KW - Gastric distension KW - Postprandial hypotension SP - 241 EP - 241 JF - BMC geriatrics JO - BMC Geriatr VL - 19 IS - 1 N2 - BACKGROUND: Postprandial hypotension (PPH) occurs frequently in the elderly and patients with type 2 diabetes, and lacks a satisfactory treatment. Gastric distension and the α-glucosidase inhibitor, acarbose, may attenuate the postprandial fall in blood pressure (BP) by complementary mechanisms. We aimed to determine whether gastric distension and acarbose have additive effects to attenuate the fall in BP induced by oral sucrose. METHODS: Ten healthy older adults (74.0 ± 1.4 yr) had measurements of BP and superior mesenteric artery (SMA) blood flow for 120 min after receiving either (i) the 'study drink' of 100 g sucrose in 300 mL of water (control treatment), (ii) a 300 mL water 'preload' 15 min before the 'study drink' (distension treatment), (iii) 100 mg acarbose dissolved in the 'study drink' (acarbose treatment) or (iv) a 300 ml water 'preload' 15 min before 100 mg acarbose dissolved in the 'study drink' (acarbose and distension treatment). RESULTS: The area under the curve (AUC)0-120min for mean arterial pressure (MAP) was greater (P = 0.005) and the maximum fall in MAP was less (P = 0.006) during treatments with acarbose. Gastric distension did not affect the MAP-AUC0-120min response to acarbose (P = 0.44) and there was no effect of gastric distension alone (P = 0.68). Both acarbose treatments attenuated the rise in SMA blood flow (P = 0.003), whereas gastric distension had no effect. CONCLUSIONS: In healthy older adults, acarbose (100 mg), but not gastric distension, attenuates the fall in BP and rise in SMA blood flow after oral sucrose. The observations support the use of acarbose, but not gastric distension, to attenuate a postprandial fall in BP. TRIAL REGISTRATION: The study was retrospectively registered at (ACTRN12618000152224) on February 02nd 2018. SN - 1471-2318 UR - https://www.unboundmedicine.com/medline/citation/31470806/A_randomized_crossover_study_of_the_acute_effects_of_acarbose_and_gastric_distension_alone_and_combined_on_postprandial_blood_pressure_in_healthy_older_adults_ L2 - https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1251-7 DB - PRIME DP - Unbound Medicine ER -