The influence of low-, normal-, and high-carbohydrate meals on blood pressure in elderly patients with postprandial hypotension

Background. Postprandial hypotension (PPH) is a common and serious disorder of blood pressure (13P) regulation in elderly people. It has been suggeste d that primarily the carbohydrate (CH) content of a meal induces the BP dec rease. Therefore, we examined the relationship between the CH content of me als and postprandial BP responses in elderly patients diagnosed with PPH. Methods. Twelve geriatric patients (aged 75 to 91 years 6 men) who were pre viously diagnosed with PPH received standardized liquid meals with low- (25 g), normal- (65 g), and high- (125 g) CH content in random order on three separate days. Systolic BP (SBP), diastolic BP, and heart rate were measure d every 5 minutes from 20 minutes before until 75 minutes after each meal. Postprandial symptoms were recorded every 15 minutes. Results. The maximum decrease in SBP was significantly smaller after the lo w-CH meal (-28 +/- 5 mm Hg) than after the normal- (-39 +/- 7 num Hg) and h igh-CH meals (-40 +/- 5 into Hg) (p < .050 between groups). In addition, th e duration of PPH was significantly shorter (p < .010), and postprandial sy mptoms were less frequent and less severe after the low-CH meal. Conclusions. Reducing the CH amount in meals induces significantly smaller decreases in SBP. shorter duration of PPH. and reduction of PPH-related sym ptoms. Therefore, limiting the CH content of an elderly patient's meal can be a clinically effective nonpharmacological treatment for PPH in elderly p atients and can reduce the risk of developing symptomatic PPH.