Comparative effects of glucose and water drinks on blood pressure and cardiac function in older subjects with and without postprandial hypotension

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 13C‐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 CO 2. 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.

Haemodynamic Response to a Standard Meal: Consideration on A Case of Significant Blood Pressure Peaks in a Diabetic Hypertensive Patient Treated with ARB and Comparison with Normal Age and Sex Matched Subjects

“…Indeed, blood flow is subject to complex regulation mechanisms, including autonomic and endocrine control [5], it is also possible that the final effect on systemic arterial BP of the local re-distribution of blood flow are self-limited. At this regard, some experimental data in dogs support that BP is not significantly changed after meal [1]; nonetheless, in our control group we found a slight increase in systemic arterial BP and this is in agreement with previous studies on humans that have shown a significant association between SBP/DBP in non-DM women and men [6]; this fact justifies the increase in BP during meal since it follows the insulin (INs) release. Nonetheless in a DM subjects we would expect a lower INs release during meal and, consequently, a lower increase in BP and in our case it was not.…”

Interoceptive accuracy moderates the response to a glucose load: a test of the predictive coding framework

“…vagal efferent innervation of the pancreas). Nonetheless, compensatory cardiovascular changes following a glucose load are necessary to prevent a postprandial fall in blood pressure [33]. Therefore, communication between the cardiovascular and glucoregulatory systems is a physiological requirement, and changes in autonomic functioning within the cardiac domain represent an important component of the homeostatic response.…”

Differences In Isotonic Beverages Compared to Mineral Water on Blood Pressure, Heart Rate and Sodium in Students of The Faculty of Nursing Universitas Prima Indonesia Underwriting Circuit Training

“…: 0.809 (p>0.05) [14]. Meanwhile, the results of systolic blood pressure given mineral water are in line with research conducted by Trahair et.al., where the results of the study experienced a significant increase in systolic blood pressure (p <0.05) in subjects with Postprandial Hypotension (PPH) [15]. The results of the analysis proved that by administering isotonic fluids, there was a significant reduction in heart rate on the first and second days (p<0.05), while on the third to fifth days (p>0.05) there was a decrease in heart rate but not significant, so it can be concluded that administration of isotonic fluids can cause a decrease in heart rate.…”