Abstract
Postprandial hypotension is a frequent disorder, occurring in ∼ 40% of nursing-home residents, and represents a major cause of morbidity and mortality. Current approaches to management are suboptimal. While it has been generally assumed that ingestion of carbohydrate has the greatest effect, the fall in blood pressure (BP) does not appear to be mediated by the consequent elevations in blood glucose and insulin. Moreover, there is evidence that fat may decrease BP to a comparable extent to carbohydrate, although onset of the response may be slower, and that the response is affected by the type of carbohydrate. It has recently been established that the rate of nutrient delivery from the stomach into the small intestine is an important determinant of the hypotensive response to carbohydrate, so that the magnitude of the fall in BP and rise in heart rate is greater when gastric emptying is relatively more rapid. In both healthy elderly subjects and patients with type 2 diabetes, the fall in BP is attenuated when gastric emptying and small intestinal carbohydrate absorption are slowed by dietary (e.g. guar) or pharmacological (e.g. acarbose) means. Conversely, gastric distension attenuates the postprandial fall in BP. Strategies for the treatment of postprandial hypotension should, therefore, potentially be directed at (i) meal composition, particularly carbohydrate type and content, (ii) slowing gastric emptying and/or small intestinal carbohydrate absorption and/or (iii) increasing postprandial gastric distension.
Keywords: Postprandial hypotension, elderly, gastric emptying, blood pressure, glucose
Current Vascular Pharmacology
Title: Postprandial Hypotension - Novel Insights into Pathophysiology and Therapeutic Implications
Volume: 4 Issue: 2
Author(s): Diana Gentilcore, Karen L. Jones, Deirdre G. O'Donovan and Michael Horowitz
Affiliation:
Keywords: Postprandial hypotension, elderly, gastric emptying, blood pressure, glucose
Abstract: Postprandial hypotension is a frequent disorder, occurring in ∼ 40% of nursing-home residents, and represents a major cause of morbidity and mortality. Current approaches to management are suboptimal. While it has been generally assumed that ingestion of carbohydrate has the greatest effect, the fall in blood pressure (BP) does not appear to be mediated by the consequent elevations in blood glucose and insulin. Moreover, there is evidence that fat may decrease BP to a comparable extent to carbohydrate, although onset of the response may be slower, and that the response is affected by the type of carbohydrate. It has recently been established that the rate of nutrient delivery from the stomach into the small intestine is an important determinant of the hypotensive response to carbohydrate, so that the magnitude of the fall in BP and rise in heart rate is greater when gastric emptying is relatively more rapid. In both healthy elderly subjects and patients with type 2 diabetes, the fall in BP is attenuated when gastric emptying and small intestinal carbohydrate absorption are slowed by dietary (e.g. guar) or pharmacological (e.g. acarbose) means. Conversely, gastric distension attenuates the postprandial fall in BP. Strategies for the treatment of postprandial hypotension should, therefore, potentially be directed at (i) meal composition, particularly carbohydrate type and content, (ii) slowing gastric emptying and/or small intestinal carbohydrate absorption and/or (iii) increasing postprandial gastric distension.
Export Options
About this article
Cite this article as:
Gentilcore Diana, Jones L. Karen, O'Donovan G. Deirdre and Horowitz Michael, Postprandial Hypotension - Novel Insights into Pathophysiology and Therapeutic Implications, Current Vascular Pharmacology 2006; 4 (2) . https://dx.doi.org/10.2174/157016106776359826
DOI https://dx.doi.org/10.2174/157016106776359826 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
A Paradigm Shift in the Development of Anti-Candida Drugs
Current Topics in Medicinal Chemistry The Main Receptors Involved in the COVID-19: A Systematic Review and Meta-Analysis
Current Medicinal Chemistry Diabetes and Its Complications: Therapies Available, Anticipated and Aspired
Current Diabetes Reviews Aquaretic Agents: Whats Beyond the Treatment of Hyponatremia?
Current Pharmaceutical Design Autonomic Nervous System Dysfunction in Sjogrens Syndrome
Current Rheumatology Reviews Ghrelin in Obesity, Physiological and Pharmacological Considerations
Mini-Reviews in Medicinal Chemistry Synthesis, Cytotoxicity and Molecular Docking Simulation of Novel bis-1,4-Dihydropyridines Linked to Aliphatic or Arene Core via Amide or Ester-Amide Linkages
Mini-Reviews in Medicinal Chemistry Immunotoxins in the Treatment of Hematologic Malignancies
Current Drug Targets Prospectives of Antihypertensive Nano-ceuticals as Alternative Therapeutics
Current Drug Targets Role of Nicotinic Acetylcholine Receptors in Cardiovascular Physiology and Pathophysiology: Current Trends and Perspectives
Current Vascular Pharmacology Biofunctional Peptides from Milk Proteins: Mineral Binding and Cytomodulatory Effects
Current Pharmaceutical Design Cancer Treatment-Induced Cardiotoxicity: a Cardiac Stem Cell Disease?
Cardiovascular & Hematological Agents in Medicinal Chemistry Use of Cocktail Probe Drugs for Indexing Cytochrome P450 Enzymes in Clinical Pharmacology Studies – Review of Case Studies
Drug Metabolism Letters Tumor Necrosis Factor: How to Make a Killer Molecule Tumor-Specific?
Current Cancer Drug Targets Peculiarities of the Clinical Course of Oxidative Protein and Lipid Modification in Children with Acute Rheumatic Fever
Endocrine, Metabolic & Immune Disorders - Drug Targets Invasive Aspergillosis: New Insights into Disease, Diagnostic and Treatment
Current Pharmaceutical Design Modulators of Voltage-Dependent Calcium Channels for the Treatment of Nervous System Diseases
Recent Patents on CNS Drug Discovery (Discontinued) Controlled Delivery of Biotechnological Products
Current Pharmaceutical Biotechnology Interaction Between Bone and Muscle in Older Persons with Mobility Limitations
Current Pharmaceutical Design NMDA Receptor Antagonists as Antidepressant and Antidementia Drugs: Recent Developments and Future Prospects
Current Medicinal Chemistry - Central Nervous System Agents