title: Postprandial and Orthostatic Hypotension Treated by Sitagliptin in a Patient with Dementia with Lewy Bodies.
abstract: BACKGROUND Postprandial hypotension, induced by an absorption of glucose from intestine, could be treated by acarbose; however, it was unclear whether dipeptidyl peptidase-4 inhibitor reduced postprandial hypotension. CASE REPORT A 78-year-old woman who had experienced episodes of dizziness and hypotension after eating was admitted to our hospital. During 24-hour ambulatory blood pressure monitoring, there were repeated episodes of marked postprandial hypotension; i.e., a significant systolic blood pressure reduction within two hours after eating (from -58 to -64 mm Hg after meals). The patient was diagnosed with dementia with Lewy bodies. The patient exhibited postprandial hyperglycemia and hypotension after a 75 g oral glucose tolerance test. After the administration of 25 mg sitagliptin, the patient's postprandial and orthostatic hypotension was reduced remarkably. Moreover, her Mini-Mental State Examination score subsequently increased (from 22 to 25 points). CONCLUSIONS The dipeptidyl peptidase-4 inhibitor sitagliptin can delay postprandial increases in glucose levels and hypotensive episodes, as well as sympathetic nervous system abnormalities and orthostatic hypotension.
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Ishikawa
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Harada
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D003704:Dementia / Q000150:complications*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016631:Lewy Bodies; D019518:Postprandial Period; D000068900:Sitagliptin Phosphate / Q000627:therapeutic use*
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D000068900:Sitagliptin Phosphate
keywords: Autonomic Nervous System Diseases; Hypotension; Hypotension, Orthostatic; Lewy Body Disease; Postprandial Period