Aging is associated with changes in cardiovascular structure and function, which predisposes elderly people to reduced blood pressure levels after meals. The authors studied cardiac systolic function in elderly hypertensive patients after eating meals with different contents of lipids, proteins, and carbohydrates. Ten elderly male hypertensive patients were studied (mean age, 69 years; range 60-80 years). No patients had a previous history of orthostatic or postprandial hypotension. Patients ate 1 of 3 pre-prepared meals: lipid meal (LM), protein meal (PM), or carbohydrate meal (CM), on different days. Mean arterial pressure, total peripheral resistance index (TPRi), cardiac index (CI), and stroke index were recorded at the end of the fasting period and then at 5, 15, 30, 45, and 60 minutes after food ingestion. After ingestion of a CM, the CI increased from 2.30 +/- 0.21 L/ min /m(2) to 2.61 +/- 0.24 L/ min /m(2) and the TPRi decreased from 3212 +/- 226 dynes / sec(2) to 2793 +/- 255 dynes / sec(2) at 45 minutes (P<.05). After the LM, the CI increased from 2.15 +/- 0.15 to 2.84 +/- 0.27 L/ min /m(2) and the TPRi decreased from 3630 +/- 274 L/ min /m(2) to 2666 +/- 282 dynes / sec(2) at 45 minutes (P<.05). After the PM, no systemic hemodynamic changes were observed. When all 3 meals were compared, the highest values of CI and the lowest values of TPRi were observed for the LM and CM. The authors' results show that fat- and carbohydrate-rich foods cause changes in the systemic hemodynamic of the elderly hypertensive patients.