A randomized, crossover study of the acute effects of acarbose and gastric distension, alone and combined, on postprandial blood pressure in healthy older adults

BMC Geriatr. 2019 Aug 30;19(1):241. doi: 10.1186/s12877-019-1251-7.


Background: Postprandial hypotension (PPH) occurs frequently in the elderly and patients with type 2 diabetes, and lacks a satisfactory treatment. Gastric distension and the α-glucosidase inhibitor, acarbose, may attenuate the postprandial fall in blood pressure (BP) by complementary mechanisms. We aimed to determine whether gastric distension and acarbose have additive effects to attenuate the fall in BP induced by oral sucrose.

Methods: Ten healthy older adults (74.0 ± 1.4 yr) had measurements of BP and superior mesenteric artery (SMA) blood flow for 120 min after receiving either (i) the 'study drink' of 100 g sucrose in 300 mL of water (control treatment), (ii) a 300 mL water 'preload' 15 min before the 'study drink' (distension treatment), (iii) 100 mg acarbose dissolved in the 'study drink' (acarbose treatment) or (iv) a 300 ml water 'preload' 15 min before 100 mg acarbose dissolved in the 'study drink' (acarbose and distension treatment).

Results: The area under the curve (AUC)0-120min for mean arterial pressure (MAP) was greater (P = 0.005) and the maximum fall in MAP was less (P = 0.006) during treatments with acarbose. Gastric distension did not affect the MAP-AUC0-120min response to acarbose (P = 0.44) and there was no effect of gastric distension alone (P = 0.68). Both acarbose treatments attenuated the rise in SMA blood flow (P = 0.003), whereas gastric distension had no effect.

Conclusions: In healthy older adults, acarbose (100 mg), but not gastric distension, attenuates the fall in BP and rise in SMA blood flow after oral sucrose. The observations support the use of acarbose, but not gastric distension, to attenuate a postprandial fall in BP.

Trial registration: The study was retrospectively registered at ( ACTRN12618000152224 ) on February 02nd 2018.

Keywords: Acarbose; Gastric distension; Postprandial hypotension.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acarbose / administration & dosage*
  • Aged
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Blood Pressure / drug effects
  • Blood Pressure / physiology*
  • Combined Modality Therapy / methods
  • Cross-Over Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Gastric Absorption / drug effects
  • Gastric Absorption / physiology
  • Glycoside Hydrolase Inhibitors / administration & dosage*
  • Heart Rate / drug effects
  • Heart Rate / physiology
  • Humans
  • Hypotension / blood
  • Hypotension / therapy*
  • Male
  • Postprandial Period / drug effects
  • Postprandial Period / physiology*
  • Retrospective Studies
  • Sucrose / administration & dosage*


  • Blood Glucose
  • Glycoside Hydrolase Inhibitors
  • Sucrose
  • Acarbose

Associated data

  • ANZCTR/ACTRN12618000152224