Postprandial hypotension in 499 elderly persons in a long-term health care facility.
OBJECTIVE
To present baseline data from a prospective study of postprandial hypotension in 499 elderly persons in a long-term health care facility.


METHODS
Analyses of baseline data for a prospective study.


METHODS
A large long-term health care facility where 499 ambulatory or wheelchair-bound residents were studied.


METHODS
The 499 residents were > or = 62 years of age, mean age 80 +/- 9 years (range 62-100), 71% female, 29% male, 66% white, 27% black, 7% Hispanic, 68% ambulatory, and 32% wheelchair-bound.


RESULTS
The mean maximal decrease in postprandial systolic and diastolic blood pressures was 15 +/- 6 mm Hg/6 +/- 2 mm Hg. The mean maximal decrease in postprandial systolic blood pressure occurred 15 minutes after eating in 13% of residents, 30 minutes after eating in 20% of residents, 45 minutes after eating in 26% of residents, 60 minutes after eating in 30% of residents, and 75 minutes after eating in 11% of residents. Of 499 residents, 118 (24%) had a maximal decrease in postprandial systolic blood pressure of > or = 20 mm Hg. The mean maximal decrease in postprandial systolic blood pressure was 24 +/- 5 mm Hg in residents with syncope in the prior 6 months and 14 +/- 5 mm Hg in residents without syncope (P < 0.0001). The mean maximal decrease in postprandial systolic blood pressure was 21 +/- 5 mm Hg in residents with falls in the preceding 6 months and 13 +/- 4 mm Hg in residents without falls (P < 0.0001). The mean maximal decrease in postprandial systolic blood pressure was significantly greater in residents treated with angiotensin-converting enzyme inhibitors, calcium channel blockers, diuretics, nitrates, digoxin, and psychotropic drugs than in residents not treated with these drugs. The mean maximal decrease in postprandial systolic and diastolic blood pressures was not significantly different in elderly blacks, Hispanics, and whites.


CONCLUSIONS
A more severe reduction in postprandial systolic blood pressure correlates with a history of syncope or falls in the previous 6 months. Long-term follow-up is being planned to determine whether a marked reduction in postprandial systolic blood pressure in elderly persons correlates with a higher incidence of falls, syncope, new coronary events, new stroke, and total mortality.
Aronow
W S
WS
Hebrew Hospital Home, Bronx, New York 10475.
Ahn
C
C
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002317:Cardiovascular Agents / Q000009:adverse effects; D004435:Eating / Q000502:physiology*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000150:complications / Q000209:etiology*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000009:adverse effects; D013575:Syncope / Q000209:etiology
D002317:Cardiovascular Agents; D011619:Psychotropic Drugs