Postprandial hypotension is a condition in which a person’s blood pressure drops after eating. In fact, “after a meal” means “after a meal.”
For people with postprandial hypotension, the simple act of standing up after a meal can cause a sharp drop in blood pressure that can trigger noticeable symptoms.
This article explains that postprandial hypotension is more common in older adults. It also details the symptoms, causes and treatments for this condition.
Condition trends in older adults
Postprandial hypotension is most common in older adults. As many as one-third of people experience some degree of postprandial hypotension, defined as a drop in systolic blood pressure of up to 20 mmHg within two hours of a meal.
For most of these people, the condition is mild and does not cause symptoms. However, in some people, postprandial hypotension can become very severe.
Postprandial hypotension is a specific form of orthostatic hypotension (a drop in blood pressure while standing). All types of orthostatic hypotension are more likely to affect people with high blood pressure, or with certain disorders that impair the autonomic nervous system, such as Parkinson’s disease and diabetes.
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Symptoms of postprandial hypotension
People with postprandial hypotension often experience dizziness, lightheadedness, weakness, and even syncope (loss of consciousness) when they stand up within an hour or two of a meal.
Symptoms tend to be worse after eating a large or carbohydrate-rich meal. Drinking alcohol before or during a meal may be another factor. These symptoms usually disappear about two hours after meals.
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Causes of postprandial hypotension
Although the cause of postprandial hypotension is not fully understood, it is thought to be related to the pooling of blood in the abdominal organs during digestion.
Due to this pooling, the amount of blood available for systemic circulation decreases, resulting in a drop in blood pressure. Standing increases this effect.
It is normal for a certain amount of blood to build up in the abdominal organs after a meal because digesting food requires increased blood flow. To compensate, the blood vessels in the legs naturally constrict as a reflex.
For postprandial hypotension, it is thought to be caused by any of the following:
- The amount of blood in the gut is exaggerated.
- The normal contraction of blood vessels in the lower extremities is diminished.
high carbohydrate foods
Eating foods high in carbohydrates seems to exacerbate postprandial hypotension. This observation has led some experts to speculate that, in people with postprandial hypotension, insulin or other blood chemicals released from high-carbohydrate meals may cause excessive dilation of blood vessels in the abdomen.
To some extent, aging is accompanied by an increase in the accumulation of blood in the abdomen that usually occurs after meals. Most older adults never experience symptoms from this increased blood buildup. But people with obvious symptoms from postprandial hypotension tend to be older.
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While there is no specific treatment for eliminating postprandial hypotension, most people can learn to manage their symptoms. Treatment consists of four elements:
- Eat small, frequent meals. Eating large meals tends to exaggerate the accumulation of blood in the abdomen. Fewer meals means less blood pooling.
- Avoid high-carb foods or foods that include bread, pasta, and potatoes. (Be sure to do your research when planning your meal. Even good-for-you fruits, like apples, mangoes, pears, and raisins, are high in carbohydrates.)
- Avoid drinking alcohol. Alcohol relaxes blood vessels and tends to prevent leg blood vessel constriction that normally compensates for blood buildup in the abdomen.
- Remain seated. Or, if symptoms are severe, lie down for an hour or two after meals. Hemoperitoneum tends to dissipate during this time after a meal.
If these measures are insufficient, other therapies commonly used to treat orthostatic hypotension are often helpful. These include:
- NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) taken before meals can cause salt retention, which increases blood volume.
- Caffeine: This causes blood vessels to constrict and may reduce symptoms.
- Guar beans Chewing Gum: This thickener slows the emptying of the stomach after meals and helps relieve symptoms.
- Exercise: Getting plenty of exercise (such as walking) between meals can improve vascular tone and reduce symptoms of postprandial hypotension.
Patients with postprandial hypotension who have diastolic heart failure and are receiving diuretics may find that withdrawing diuretics from their diet significantly improves their symptoms.
If symptoms are severe and cannot be controlled with other measures, subcutaneous An injection of octreotide (a drug that acts like a pancreatic hormone somatostatin) before meals may help reduce blood flow to the intestines. However, this treatment is very expensive and can cause serious side effects.
Since “postprandial” means “after a meal,” it makes sense that postprandial hypotension refers to a sharp drop in blood pressure after standing after a meal. This decline can trigger predictable symptoms such as dizziness, lightheadedness, weakness, and even loss of consciousness. The condition remains a mystery to doctors, but they think it may be related to the pooling of blood that occurs in the abdominal organs when food is digested. In other words, blood is concentrated in one place rather than circulating throughout the body, causing blood pressure to drop. Paying attention to four tips can help you manage postprandial hypotension.
Postprandial hypotension can sometimes be a serious problem, especially in older adults. However, most people with the disease have learned how to manage it. Fundamentally changing the way you eat is never easy, so try to make small changes at a time rather than sweeping changes.