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Haemodynamic and neurohumoral effects of caffeine in elderly patients with symptomatic postprandial hypotension: a double-blind, randomized, placebo-controlled study.
Clin Sci (Lond). 1994 Aug; 87(2):259-67.CS

Abstract

1. The aim of this study was to determine the effects of caffeine on haemodynamic and neurohumoral responses to meal ingestion in elderly patients with a history of symptomatic postprandial hypotension. 2. Postprandial hypotension is a common disorder of blood pressure regulation in the elderly, associated with falls and syncope. The pathophysiological mechanism is thought to be related to impaired vascular compensation for splanchnic blood pooling after a meal. Since caffeine inhibits vasodilatory adenosine receptors in the splanchnic circulation, we postulated that caffeine would reduce splanchnic blood pooling and prevent the development of postprandial hypotension. 3. We conducted a randomized, double-blind, placebo-controlled, cross-over study in nine elderly patients [age 76 +/- 9 (SD) years] with histories of symptomatic postprandial hypotension. Standardized 1674kJ liquid meals with 250 mg of caffeine or placebo were given on two occasions, at least 1 week apart. Blood pressure, heart rate, forearm vascular resistance (by venous occlusion plethysmography), and plasma caffeine and catecholamine levels were measured. Cardiac and splanchnic blood volume were determined by radionuclide scans. 4. By 30 min after both caffeine and placebo meal studies, supine mean arterial blood pressure fell significantly (P = 0.006) by 31 +/- 7 and 19 +/- 6 mmHg, respectively (mean +/- SEM, between group difference was not significant). Heart rate, cardiac output and splanchnic blood volume increased significantly, but to a similar extent, after caffeine and placebo. Forearm vascular resistance was unchanged after both meals. 5. Oral caffeine given with a meal does not reduce splanchnic blood pooling nor prevent postprandial hypotension in symptomatic elderly patients.

Authors+Show Affiliations

Hebrew Rehabilitation Center for Aged, Boston, Massachusetts.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

7924173

Citation

Lipsitz, L A., et al. "Haemodynamic and Neurohumoral Effects of Caffeine in Elderly Patients With Symptomatic Postprandial Hypotension: a Double-blind, Randomized, Placebo-controlled Study." Clinical Science (London, England : 1979), vol. 87, no. 2, 1994, pp. 259-67.
Lipsitz LA, Jansen RW, Connelly CM, et al. Haemodynamic and neurohumoral effects of caffeine in elderly patients with symptomatic postprandial hypotension: a double-blind, randomized, placebo-controlled study. Clin Sci (Lond). 1994;87(2):259-67.
Lipsitz, L. A., Jansen, R. W., Connelly, C. M., Kelley-Gagnon, M. M., & Parker, A. J. (1994). Haemodynamic and neurohumoral effects of caffeine in elderly patients with symptomatic postprandial hypotension: a double-blind, randomized, placebo-controlled study. Clinical Science (London, England : 1979), 87(2), 259-67.
Lipsitz LA, et al. Haemodynamic and Neurohumoral Effects of Caffeine in Elderly Patients With Symptomatic Postprandial Hypotension: a Double-blind, Randomized, Placebo-controlled Study. Clin Sci (Lond). 1994;87(2):259-67. PubMed PMID: 7924173.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Haemodynamic and neurohumoral effects of caffeine in elderly patients with symptomatic postprandial hypotension: a double-blind, randomized, placebo-controlled study. AU - Lipsitz,L A, AU - Jansen,R W, AU - Connelly,C M, AU - Kelley-Gagnon,M M, AU - Parker,A J, PY - 1994/8/1/pubmed PY - 1994/8/1/medline PY - 1994/8/1/entrez SP - 259 EP - 67 JF - Clinical science (London, England : 1979) JO - Clin Sci (Lond) VL - 87 IS - 2 N2 - 1. The aim of this study was to determine the effects of caffeine on haemodynamic and neurohumoral responses to meal ingestion in elderly patients with a history of symptomatic postprandial hypotension. 2. Postprandial hypotension is a common disorder of blood pressure regulation in the elderly, associated with falls and syncope. The pathophysiological mechanism is thought to be related to impaired vascular compensation for splanchnic blood pooling after a meal. Since caffeine inhibits vasodilatory adenosine receptors in the splanchnic circulation, we postulated that caffeine would reduce splanchnic blood pooling and prevent the development of postprandial hypotension. 3. We conducted a randomized, double-blind, placebo-controlled, cross-over study in nine elderly patients [age 76 +/- 9 (SD) years] with histories of symptomatic postprandial hypotension. Standardized 1674kJ liquid meals with 250 mg of caffeine or placebo were given on two occasions, at least 1 week apart. Blood pressure, heart rate, forearm vascular resistance (by venous occlusion plethysmography), and plasma caffeine and catecholamine levels were measured. Cardiac and splanchnic blood volume were determined by radionuclide scans. 4. By 30 min after both caffeine and placebo meal studies, supine mean arterial blood pressure fell significantly (P = 0.006) by 31 +/- 7 and 19 +/- 6 mmHg, respectively (mean +/- SEM, between group difference was not significant). Heart rate, cardiac output and splanchnic blood volume increased significantly, but to a similar extent, after caffeine and placebo. Forearm vascular resistance was unchanged after both meals. 5. Oral caffeine given with a meal does not reduce splanchnic blood pooling nor prevent postprandial hypotension in symptomatic elderly patients. SN - 0143-5221 UR - https://www.unboundmedicine.com/medline/citation/7924173/Haemodynamic_and_neurohumoral_effects_of_caffeine_in_elderly_patients_with_symptomatic_postprandial_hypotension:_a_double_blind_randomized_placebo_controlled_study_ L2 - https://portlandpress.com/clinsci/article-lookup/doi/10.1042/cs0870259 DB - PRIME DP - Unbound Medicine ER -