Kenneth M Madden1,2,3, Boris Feldman4, Graydon S Meneilly4. 1. Gerontology and Diabetes Research Laboratory, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada. Kenneth.Madden@vch.ca. 2. Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada. Kenneth.Madden@vch.ca. 3. Allan M. McGavin Chair in Geriatric Medicine, Room 7185, Gordon and Leslie Diamond Health Care Centre, 2775 Laurel St., Vancouver, BC, V5Z 1M9, Canada. Kenneth.Madden@vch.ca. 4. Gerontology and Diabetes Research Laboratory, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Abstract
PURPOSE: Postprandial hypotension (PPH) is a common but poorly understood etiology for fainting in older adults. One potential mechanism is age-related baroreflex dysfunction. We examined baroreflex function in older adults with PPH and without PPH (noPPH) during a standardized meal test. METHODS: 57 adults (age ≥ 65; 24 PPH, 33 noPPH, mean age 77.9 ± 0.9 years, 54% female) were recruited and had meal tests performed. The baroreflex effectiveness index (BEI, %) and baroreflex sensitivity (BRS, ms/mm Hg) were calculated using the sequence method. RESULTS: Baseline BEI (22 ± 2 versus 23 ± 2 percent, t = - 0.411, p = 0.682) and BRS (14.1 ± 2.4 versus 13.8 ± 2.5 ms/mm of Hg, t = - 0.084, p = 0.933) were similar in PPH and noPPH subjects. During the meal test PPH subjects showed significantly lower BEI as compared to noPPH subjects (time × PPH, F = 2.791, p = 0.042), while there was no difference in the postprandial change in BRS (time, F = 0.618, p = 0.605). CONCLUSION: Patients with PPH demonstrated an acute postprandial decrease in baroreflex effectiveness during meal testing as compared with normal subjects, suggesting a potential contributing mechanism for this condition.
PURPOSE: Postprandial hypotension (PPH) is a common but poorly understood etiology for fainting in older adults. One potential mechanism is age-related baroreflex dysfunction. We examined baroreflex function in older adults with PPH and without PPH (noPPH) during a standardized meal test. METHODS: 57 adults (age ≥ 65; 24 PPH, 33 noPPH, mean age 77.9 ± 0.9 years, 54% female) were recruited and had meal tests performed. The baroreflex effectiveness index (BEI, %) and baroreflex sensitivity (BRS, ms/mm Hg) were calculated using the sequence method. RESULTS: Baseline BEI (22 ± 2 versus 23 ± 2 percent, t = - 0.411, p = 0.682) and BRS (14.1 ± 2.4 versus 13.8 ± 2.5 ms/mm of Hg, t = - 0.084, p = 0.933) were similar in PPH and noPPH subjects. During the meal test PPH subjects showed significantly lower BEI as compared to noPPH subjects (time × PPH, F = 2.791, p = 0.042), while there was no difference in the postprandial change in BRS (time, F = 0.618, p = 0.605). CONCLUSION:Patients with PPH demonstrated an acute postprandial decrease in baroreflex effectiveness during meal testing as compared with normal subjects, suggesting a potential contributing mechanism for this condition.
Authors: G A Rongen; W J Bos; J W Lenders; G A van Montfrans; H J van Lier; J van Goudoever; K H Wesseling; T Thien Journal: Am J Hypertens Date: 1995-03 Impact factor: 2.689
Authors: N Takahashi; M Nakagawa; T Saikawa; T Ooie; T Akimitsu; K Kaneda; M Hara; T Iwao; H Yonemochi; M Ito; T Sakata Journal: J Am Coll Cardiol Date: 1999-07 Impact factor: 24.094