title: Intraindividual reproducibility of postprandial hypotension.
abstract: BACKGROUND
  Postprandial hypotension (PPH) is increasingly recognized as a common cause of falls and syncopes in the elderly. The diagnosis of PPH is based on the measurement of meal-induced blood pressure (BP) changes. Although the problem of intraindividual reproducibility of PPH is of clinical importance, it has not been extensively studied.
  
  
  OBJECTIVE
  To assess the intraindividual reproducibility of PPH.
  
  
  METHODS
  50 patients (42 women and 8 males, 83 +/- 8 years) were included in the study. To evaluate PPH, we measured the BP before and every 15 min for 2 h after the start of a standardized mixed meal. The PPH was defined as a decrease in systolic BP of 20 mm Hg or more. Three sets of BP were obtained for each subject on 2 successive days: (1) between 08.00 and 10.00 h and (2) between 16.00 and 18.00 h on the 1st day and (3) between 08.00 and 10.00 h on the 2nd day.
  
  
  RESULTS
  32 participants (64%) experienced PPH on at least one test. Among them, 19 (38%) had PPH on the first test, 16 (32%) had PPH on the second test, and 21 (42%) had PPH on the third test. The intraindividual reproducibility of PPH was good when the results of the two morning tests were compared together (kappa coefficient = 0.6), but was low when the morning test results were compared with the afternoon test results of the 1st day (kappa coefficient = 0.1).
  
  
  CONCLUSIONS
  Because of the good reproducibility of postprandial BP changes, we conclude that the diagnosis of PPH may be based on a single standardized test. However, the test must be performed under circumstances (time of the meal, medications) similar to those in which the symptoms occurred.
authors.affiliation: Service de Médecine Interne et Gériatrie, CHRU Lille, France. f-puisieux@chru-lille.fr
authors.forename: François
authors.initials: F
authors.lastname: Puisieux
authors.forename: Dominique
authors.initials: D
authors.lastname: Court
authors.forename: Eddy
authors.initials: E
authors.lastname: Baheu
authors.forename: Christophe
authors.initials: C
authors.lastname: Dipompeo
authors.forename: Hélène
authors.initials: H
authors.lastname: Bulckaen
authors.forename: Philippe
authors.initials: P
authors.lastname: Dewailly
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D004032:Diet; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D019518:Postprandial Period / Q000502:physiology*; D015995:Prevalence; D015203:Reproducibility of Results; D013575:Syncope / Q000209:etiology