title: Postprandial hypertension, an overlooked risk marker for arteriosclerosis.
abstract: OBJECTIVE
  Increased blood pressure (BP) variability is suggested to be a risk factor for cardiovascular disease. Although a postprandial decline in BP is a frequently observed phenomenon in the elderly, little attention has been paid to the clinical and diagnostic significance of postprandial BP change. Here, we aimed to clarify the possible association between postprandial BP dysregulation and arteriosclerosis.
  
  
  METHODS
  The study subjects were 1339 apparently healthy middle-aged to elderly persons (66 ± 9 years old). Postprandial changes in BP were calculated by two readings on the same day, one just before lunch with a standardized Japanese meal and the second 30 min after lunch. Arteriosclerosis was assessed by carotid intima-media thickness and brachial-to-ankle pulse wave velocity.
  
  
  RESULTS
  Mean preprandial and postprandial systolic BP was 127 ± 18 and 123 ± 18 mmHg respectively. One hundred and twelve subjects (8.4%) showed a greater than 20-mmHg postprandial decline in systolic BP, while 129 (9.6%) showed a greater than 10-mmHg increase. Arteriosclerosis was significantly higher in both postprandial hypotensive and hypertensive subjects. The postprandial changes in systolic BP were strongly associated with preprandial systolic BP (r = 0.335, p < 0.001). The association between postprandial hypotension and increased arteriosclerosis was therefore lost after adjustment for basal systolic BP. Multiple linear regression analysis adjusted for possible covariates, including basal BP, identified a postprandial increase in BP as an independent determinant of insulin resistance as assessed by HOMA-IR (β = 0.093, p < 0.001), carotid thickness (β = 0.086, p = 0.001) and pulse wave velocity (β = 0.170, p < 0.001).
  
  
  CONCLUSIONS
  Postprandial increase in BP is a novel risk marker for arteriosclerosis.
authors.affiliation: Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Toon City, Ehime 791-0295, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Uetani
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tabara
authors.forename: Michiya
authors.initials: M
authors.lastname: Igase
authors.forename: Haiyan
authors.initials: H
authors.lastname: Guo
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kido
authors.forename: Namiko
authors.initials: N
authors.lastname: Ochi
authors.forename: Rie
authors.initials: R
authors.lastname: Takita
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kohara
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miki
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001161:Arteriosclerosis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001794:Blood Pressure; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D007022:Hypotension / Q000150:complications / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019518:Postprandial Period; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D059289:Vascular Stiffness