Postprandial hypotension is associated with more rapid gastric emptying in healthy older individuals

Abstract

Background: Postprandial hypotension (PPH) occurs frequently in older individuals with disease and/or living in residential care, but its prevalence in "healthy" older individuals has not been evaluated in large cohorts. PPH is associated with substantial morbidity and increased mortality; current management is suboptimal. Recent studies suggest that the magnitude of the postprandial fall in blood pressure (BP) is related to the rate of gastric emptying (GE), so that relatively more rapid GE may potentially be a risk factor for PPH. We aimed to determine the prevalence of, and evaluate the association of GE with PPH.

Methods: A total of 88 healthy "older", community-dwelling residents (47 women, 41 men; age 71.0 ± 0.5 years) attended a clinical research laboratory on a single occasion. Individuals consumed a 300 mL drink containing 75 g glucose and 150 mg C(13)-acetate. Exhaled breath was obtained for analysis of (13)CO2 and calculation of the 50% GE time (T50). BP and heart rate were assessed with an automated device.

Results: Eleven (12.8%) of 86 subjects had PPH (2 had diabetes and were excluded). GE was faster in subjects with PPH than the remainder of the group (T50 118.0 ± 9.4 vs 142.3 ± 4.6 minutes, P < .05).

Conclusions: We conclude the prevalence of PPH in a cohort of otherwise healthy "older" individuals is 12.8% and PPH is associated with relatively more rapid GE. Therapies that slow GE may be useful in the management of PPH.

Keywords: Postprandial; blood pressure; gastric emptying; hypotension.