Postprandial systolic blood pressure responses of older people in residential care: association with risk of falling

Gerontology. Jul-Aug 2003;49(4):260-4. doi: 10.1159/000070408.

Abstract

Background: The association between postprandial blood pressure, falls and medications is controversial.

Objective: To investigate cardiovascular responses to meals in elderly people together with clinical associations and therapeutic issues.

Methods: A cross-sectional observational study of 179 semi-independent older people (age 83.2 +/- 7.0 years) in residential care facilities was undertaken. Data on the frequency of falls, medical and medication history and measurement of blood pressure before and after a breakfast meal, and then after standing and walking after the meal were documented.

Results: Postprandial hypotension (>/=20 mm Hg fall in systolic blood pressure (SBP)) and low absolute SBP (</=115 mm Hg) were common after meals and exacerbated by standing. Risk factors for low postprandial SBP included use of selective serotonin reuptake inhibitors (OR = 4.3, CI 1.4-13.1, p = 0.006), antipsychotic medications (OR = 5.2, CI 1.4-19.2, p = 0.007) and a history of smoking (OR = 4.7, CI 1.5-14.9, p = 0.005). Antihypertensive therapy ameliorated the postprandial decline in blood pressure. The incidence of falls was increased only in the 10% of subjects with low postprandial SBP.

Conclusions: Significant adverse cardiovascular change is common after meals in older people and a postprandial SBP of <115 mm Hg was associated with a history of falls. Selective serotonin reuptake inhibitors and antipsychotic medications were associated with low postprandial SBP, which may provide a mechanism for their association with falls. Hypertension was positively and antihypertensive therapy negatively associated with postprandial hypotension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Aging / blood*
  • Blood Pressure*
  • Female
  • Hemodynamics
  • Humans
  • Male
  • Nursing Homes*
  • Postprandial Period*
  • Risk Factors
  • Systole