Comparative effects of glucose and water drinks on blood pressure and cardiac function in older subjects with and without postprandial hypotension. Issue 13 (12th July 2017)

• Record Type: Journal Article
• Authors: Trahair, Laurence G.; Rajendran, Sharmalar; Visvanathan, Renuka; Chapman, Matthew; Stadler, Daniel; Horowitz, Michael; Jones, Karen L.
• Is Part Of: Physiological reports. Volume 5:Issue 13(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-07-12
• Subjects: Autonomic function -- baroreflex -- blood pressure -- echocardiography -- glucose -- hypotension; Physiology -- Periodicals; 571
• DOI: 10.14814/phy2.13341
• Languages: English
• ISSNs: 2051-817X

Abstract

Abstract: Postprandial hypotension (PPH) occurs frequently and is thought to reflect an inadequate increase in cardiac output to compensate for the rise in splanchnic blood flow after a meal. Gastric distension by water attenuates the postprandial fall in blood pressure (BP). Cardiac hemodynamics (stroke volume (SV), cardiac output (CO), and global longitudinal strain (GLS)) have hitherto not been measured in PPH. We sought to determine the comparative effects of water and glucose drinks on cardiac hemodynamics in healthy older subjects and individuals with PPH. Eight healthy older subjects (age 71.0 ± 1.7 years) and eight subjects with PPH (age 75.5 ± 1.0 years) consumed a 300 mL drink of either water or 75 g glucose (including 150 mg 13 C‐acetate) in randomized order. BP and heart rate (HR) were measured using an automatic device, SV, CO, and GLS by transthoracic echocardiography and gastric emptying by measurement of 13 CO2 . In both groups, glucose decreased systolic BP ( P < 0.001) and increased HR, SV, and CO ( P < 0.05 for all). The fall in systolic BP was greater ( P < 0.05), and increase in HR less ( P < 0.05), in the PPH group, with no difference in SV or CO. Water increased systolic BP ( P < 0.05) in subjects with PPH and, in both groups, decreased HR ( P < 0.05) without affecting SV, CO, or GLS. In subjects with PPH, the hypotensive response to glucose and the pressor response to water were related ( R = −0.75, P < 0.05). These observations indicate that, in PPH, the hypotensive response to oral glucose is associated with inadequate compensatory increases in CO and HR, whereas the pressor response to water ingestion is maintained and, possibly, exaggerated. Abstract : The comparative effects of water and glucose drinks on cardiac hemodynamics were compared in healthy older subjects and individuals with postprandial hypotension (PPH). In PPH, the hypotensive response to oral glucose was shown to be associated with inadequate compensatory increases in cardiac output and heart rate, whereas the pressor response to water ingestion is maintained and, possibly, exaggerated.