Het effect van het tijdstip van voedselinname op de bloeddruk en klachten na de maaltijd bij geriatrische patiënten met postprandiale hypotensie

To examine the effect of the time of food intake on postprandial blood-pressure (BP) responses in geriatric patients.

Design

Descriptive.

Method

A standardised liquid test meal was given in the morning, at noon, or in the evening in random order on 3 separate days to 14 patients (6 male and 8 female, aged 66-97 years) who had been admitted to the geriatric ward in the period March-August 2000 and had postprandial hypotension. Systolic BP, diastolic BP and heart rate were measured with an ambulatory BP device every 10 minutes starting 20 minutes before until 90 minutes after each meal. Patients were monitored for postprandial symptoms every 15 minutes. Postprandial hypotension was defined as a reduction in blood pressure ≥ 20 mmHg within 90 minutes after the meal.

Results

Reductions in systolic and diastolic BP occurred after each test meal. The maximum systolic BP reduction was smaller in the evening (–18 mmHg; SEM: 3) than in the morning (–29 mmHg; 2) or afternoon (–34 mmHg; 4). 8 patients showed no postprandial hypotension in the evening, whereas all patients had postprandial hypotension in the morning or afternoon. The duration of postprandial hypotension was shorter and postprandial symptoms were less frequent and less severe in the evening than in the morning or afternoon.

Conclusion

In geriatric patients with postprandial hypotension, postprandial BP responses varied depending on the time of day, with less postprandial hypotension and symptoms in the evening.

Ned Tijdschr Geneeskd 2005;149:1457-62