K C Stewart1, D Subramanian, U J Neal, A J Hanson. 1. Angela J Hanson, MD, Assistant Professor, Geriatric Medicine, University of Washington School of Medicine, 325 9th Ave, Box 359755, Seattle, WA, USA 98104, Phone: 206-897-5393, Fax: 206-744-9976, Email: hansonaj@uw.edu.
Abstract
OBJECTIVE: Postprandial hypotension (PPH) is a common phenomenon among older adults. The degree to which individuals experience PPH is related to cerebrovascular risk factors and the presence of neurodegenerative diseases such as Alzheimer's disease (AD). Carrier status of the E4 allele of the apolipoprotein E (APOE) gene is a risk factor for AD and influences a variety of responses to metabolic and dietary interventions. However, it is unknown whether APOE genotype influences the risk of PPH and whether type of meal can mediate that response. DESIGN: Acute meal study with a crossover design. PARTICIPANTS: 32 cognitively healthy older adults with (n=18) and without (n=14) E4+ carrier status. INTERVENTION: As a part of an ongoing meal study we examined the postprandial blood pressure response after ingestion of a high carbohydrate (HCM) and high fat meal (HFM). MEASUREMENTS: Blood pressure measurements were taken at 7 time points and change scores, area under the curve (AUC) scores were calculated. Data were analyzed by repeated measures ANOVA as well as Pearson correlation. RESULTS: Both meals produced a sustained drop in systolic (SBP) and diastolic (DBP) blood pressure, with 37.5% of participants meeting criteria for PPH. Participants carrying the E4+ risk gene experienced a larger decrease in SBP than E4- participants, and this was significantly different after the HFM (E4+ AUC = -30.8 ± 7.6, E4- AUC = -0.2 ± 8.7, p=0.015). Increasing age was associated with a larger drop in postprandial blood pressure but only for the E4+ group after the HFM (p=0.002). CONCLUSIONS: These data suggest that E4+ individuals experience a greater postprandial blood pressure response particularly following high fat feeding, and this effect becomes more pronounced with age. The prevalence of PPH may play a role in the development of AD and may be mediated by diet.
OBJECTIVE: Postprandial hypotension (PPH) is a common phenomenon among older adults. The degree to which individuals experience PPH is related to cerebrovascular risk factors and the presence of neurodegenerative diseases such as Alzheimer's disease (AD). Carrier status of the E4 allele of the apolipoprotein E (APOE) gene is a risk factor for AD and influences a variety of responses to metabolic and dietary interventions. However, it is unknown whether APOE genotype influences the risk of PPH and whether type of meal can mediate that response. DESIGN: Acute meal study with a crossover design. PARTICIPANTS: 32 cognitively healthy older adults with (n=18) and without (n=14) E4+ carrier status. INTERVENTION: As a part of an ongoing meal study we examined the postprandial blood pressure response after ingestion of a high carbohydrate (HCM) and high fat meal (HFM). MEASUREMENTS: Blood pressure measurements were taken at 7 time points and change scores, area under the curve (AUC) scores were calculated. Data were analyzed by repeated measures ANOVA as well as Pearson correlation. RESULTS: Both meals produced a sustained drop in systolic (SBP) and diastolic (DBP) blood pressure, with 37.5% of participants meeting criteria for PPH. Participants carrying the E4+ risk gene experienced a larger decrease in SBP than E4- participants, and this was significantly different after the HFM (E4+ AUC = -30.8 ± 7.6, E4- AUC = -0.2 ± 8.7, p=0.015). Increasing age was associated with a larger drop in postprandial blood pressure but only for the E4+ group after the HFM (p=0.002). CONCLUSIONS: These data suggest that E4+ individuals experience a greater postprandial blood pressure response particularly following high fat feeding, and this effect becomes more pronounced with age. The prevalence of PPH may play a role in the development of AD and may be mediated by diet.
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