Effects of Meal Ingestion and Active Standing on Blood Pressure in Patients ≥60 Years of Age

Imai, Chiharu; Muratani, Hiromi; Kimura, Yorio; Kanzato, Naomi; Takishita, Shuichi; Fukiyama, Koshiro

« Previous Next »American Journal of Cardiology
Volume 81, Issue 11 , Pages 1310-1314, 1 June 1998

Effects of Meal Ingestion and Active Standing on Blood Pressure in Patients ≥60 Years of Age☆

Chiharu Imai, MD
- Third Department of Internal Medicine, University of the Ryukyus School of Medicine, Okinawa, Japan
- Address for reprints: Chiharu Imai, MD, Third Department of Internal Medicine, University of the Ryukyus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa 903-01, Japan
Hiromi Muratani, MD
- Third Department of Internal Medicine, University of the Ryukyus School of Medicine, Okinawa, Japan
Yorio Kimura, MD
- Third Department of Internal Medicine, University of the Ryukyus School of Medicine, Okinawa, Japan
Naomi Kanzato, MD
- Third Department of Internal Medicine, University of the Ryukyus School of Medicine, Okinawa, Japan
Shuichi Takishita, MD
- National Cardiovascular Center, Osaka, Japan
Koshiro Fukiyama, MD
- Third Department of Internal Medicine, University of the Ryukyus School of Medicine, Okinawa, Japan

Received 17 July 1997; received in revised form 9 February 1998; accepted 9 February 1998.

Abstract

Postprandial hypotension and orthostatic hypotension occur often in elderly patients. In the present study, we examined hemodynamic and humoral responses to meal ingestion and active standing in 20 patients ≥60 years of age who were free of apparent autonomic and cardiac dysfunction. For a time-control study, water was given instead of a meal to 19 of the 20 patients. After the meal ingestion, there was a fall in systolic blood pressure (BP) in 6 patients of >20 mm Hg, whereas the fall in systolic BP during the control study was not >20 mm Hg in any patient. The low-frequency power of the systolic BP wave, an index of peripheral sympathetic activity, was significantly increased only in the patients without postprandial hypotension. The postprandial changes in systolic BP were correlated with the changes in the low-frequency power of the systolic BP wave (r = 0.61; p <0.01), but they were not correlated with the changes in plasma norepinephrine, insulin, cardiac output, or parameters obtained by the spectral analysis of the RR interval. The systolic BPs in the upright position were comparable after the meal and the water ingestion. Thus, the effects of meal ingestion and upright position on BP are not additive. Dysfunction of peripheral sympathetic control of vascular tone may contribute to the postprandial hypotension in elderly patients.