Characteristics Associated with the Postprandial Hypotensive Response in Falling Older Adults

Abstract

RÉSUMÉIl a été démontré que l’intensité de la réponse hypotensive postprandiale (RHP) peut constituer un facteur de risque pour les chutes, les fractures et le décès. Bien que ce risque ait été bien établi, les cliniques de chutes font rarement des analyses liées aux repas, en raison de contraintes logistiques. Afin de mieux cibler les patients à risque de RHP parmi les personnes âgées affectées par des chutes, cette étude a examiné les caractéristiques individuelles associées à des RHP plus intenses. Cinquante-deux patients (âge moyen : 77,8 ± 0,9 ans, 29 femmes, 23 hommes) référés par des cliniques de prévention des chutes ont été recrutés pour un repas-test de 90 minutes. Les variables significatives ont ensuite été insérées dans un modèle linéaire multivarié incluant l’âge, le sexe, la présence de diabète, la présence d’hypertension, la pression systolique de base (PSB) et la chute de la PSB orthostatique. Bien que de plus amples recherches soient nécessaires, notre étude suggère que les hommes, les patients présentant une tension artérielle élevée et ceux avec une chute orthostatique pourraient être plus à risque de réponses hémodynamiques postprandiales plus intenses.

Acute Effects of Whey Protein, Alone And Mixed With Other Macronutrients, On Blood Pressure And Heart Rate In Older Men

“…Limitations of this study include that it was only conducted in men. While women tend to have a lower baseline BP that would intuitively predispose them lower BP levels after a meal, we and others have shown that the magnitude of the postprandial fall in BP is directly related to baseline BP such that the fall is greater in those who are hypertensive [13,14] Further limitations include that the participants were sitting for the entire study day, to standardize study conditions and the number of participants was relatively small. Nevertheless, the observed decreases in BP and HR were clear cut.…”

“…Furthermore, the hypotensive effect of whey protein was prolonged, with a sustained reduction in SBP being evident at 3 hours after the whey protein drink ingestion. It has been suggested that hypertensive men may be of particular risk of blood pressure falls following food intake [13]. The current study aimed to determine the effect of whey protein, replacing some of the whey protein with isocaloric amounts of glucose and fat, and adding carbohydrate and fat to the whey protein, on blood pressure and heart rate responses in older men for 3 hours following the drink.…”

Acute effects of whey protein, alone and mixed with other macronutrients, on blood pressure and heart rate in older men

“…Limitations of this study include that it was only conducted in men. While women tend to have a lower baseline BP that would intuitively predispose them lower BP levels after a meal, we and others have shown that the magnitude of the postprandial fall in BP is related directly to baseline BP such that the fall is greater in those who are hypertensive [ 9 , 15 ] Further limitations include that the participants remained sitting to standardize study conditions and the number of participants was relatively small. Nevertheless, the observed decreases in BP and HR were clear cut.…”

“…Furthermore, the hypotensive effect of a whey protein drink was prolonged, with a sustained reduction in SBP being evident at 3 h after ingestion. It has been suggested that hypertensive men may be of particular risk of blood pressure falls following food intake [ 9 ]. The current study aimed to determine in older men the effects of whey protein, when ingested in a lower quantity but with carbohydrate and fat as occurs frequently in a “real world” setting, on blood pressure and heart rate for 3 h. We hypothesized that the hyportensive effects of whey protein containing drinks would be dependent on the energy rather than protein content of the drink and often persist for more than 2 h.…”

Baroreflex function and postprandial hypotension in older adults

“…All subjects had to be 65 years of age or over, and were referred to the Falls Prevention Clinic (Vancouver General Hospital) as part of an ongoing protocol used in previous studies [7,8]. The falls clinic does not see subjects with any cognitive issues (mini-mental status testing must be higher than 26/30), making this an exclusion criteria.…”