Postprandial hypotension common in diabetics

Postprandial hypotension (PPH) is common among diabetic patients and is tied to high systolic blood pressure (SBP) before meals, a new study has found.

The study included 300 diabetes patients (median age, 70 years) who were asked to measure their blood pressure at six points: just before and just after a meal, and 30, 60, 90, and 120 minutes after the main meal of the day. PPH was defined as an SBP decrease of ≥20 mm Hg relative to the pre-meal blood pressure within 2 hours after the meal.

Fifty percent (n=150) of the participants were positive for PPH, of whom only 15 experienced associated symptoms. Age, glycated haemoglobin, and pre-meal SBP were all elevated in PPH patients.

Multiple logistic regression analysis revealed that higher SBP measurements before a meal significantly increased the risk of PPH by over 50 percent (odds ratio [OR], 1.56, 95 percent confidence interval [CI], 1.30–1.86; p<0.001). This was also true, and even stronger, in the subgroup of patients who were not on antihypertensive medication (OR, 13.02, 95 percent CI, 1.63–103.93; p=0.012).

In another sub-analysis, the researchers found that age, glycated haemoglobin levels, and the coefficients of variation of R-R intervals were all likewise significant correlates asymptomatic PPH.

“Patients with diabetes need to be monitored for hypertension to prevent development of complications and PPH,” the researchers said. “Furthermore, treatment of older adults with diabetes, patients with uncontrolled diabetes, or diabetes-related autonomic nervous system disorders should include PPH monitoring, even when subjective symptoms have not been reported.”