Clinical Impact and Mechanism of Postprandial Hypotension

Overview

Food intake may cause a temporary but significant decline of blood pressure in susceptible people. If the systolic blood pressure falls by 20 mm Hg or more after food ingestion this indicates postprandial hypotension. This phenomenon can be asymptomatic or accompanied by a variety of neurological or cardiovascular symptoms. Postprandial hypotension occurs more commonly in elderly people, patients with hypertension, diabetes or autonomic nervous system failure. The mechanism of postprandial hypotension is not completely understood. It may be associated with ageing, arterial hypertension, impairment of the autonomic nervous system, insulin, vasoactive gastrointestinal hormones, disproportionate splanchnic blood pooling, and altered gastric motility. Food composition and its temperature are also significant.We found a 45% incidence of postprandial hypotension in a group of hypertensive patients (41 females, 48 males, mean age 67±12 years). The maximal decrease in systolic blood pressure in subjects with identified postprandial hypotension occurred most frequently 30 minutes after a standardized meal. The use of antihypertensives was not associated with a higher postprandial blood pressure decline. However this association was noted at the borderline level of statistical significance (p=0.05) with benzodiazepine treatment. In accordance with the literature we affirm that postprandial hypotension is a common disorder of blood pressure regulation, which may interfere with blood pressure measurements. Consequently, this phenomenon should be considered when evaluating the effects of antihypertensive medications in everyday routine.

Key words:
postprandial hypotension -⁠ arterial hypertension -⁠ antihypertensive treatment.