February 2018 Vol. 6 No.2

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Review

Postprandial Hypotension in Elderly

IGP Suka Aryana, Daniel Winarto and RA Tuty Kuswardhani

Geriatric Division of Internal Medicine Department, Medical Faculty ofUdayana University/Sanglah Teaching Hospital Denpasar, Bali, Indonesia

*Corresponding Author’s E-mail: aryanasuka@yahoo.com
Tel/fax: +62361246663
HP +628164724600

Accepted February 07, 2018

Abstract

A substansial declining of blood pressure after a meal was first reported in 1977, in 65-year-old male who was diagnosed with Parkinson Disease. He experienced visual disturbance than dizziness following an oral glucose load, which his systolic blood pressure dropped from 200 to 105 mmHg. Not long after that, a prospective study showed that postprandial hypotension (PPH) was common among geriatric patients who stayed in nursing home (LIpsitz et al, 1983). Postprandial hypotension has been defined as a fall in systolic blood pressure > 20 mmHg, or a decrease to ≤ 90 mmHg when the preprandial blood pressure is ≥ 100 mmHg, within 2 hours of a meal. This suddenly decrease in blood pressure is related with a number of symptoms, including dizziness, syncope, visual disturbance, falls, angina, stroke and eventually death (Fisher et al., 2005). All of these manifestations can result in more complications and overuse of heath-care with increasing cost burden (Lipsitz et al., 1986). Postprandial hypotension is a common phenomenon in geriatric population, but are frequently missed and undetected because the majority of the patients don’t have any particular signs and symptoms (Barochiner, et al 2014). So far, there is still lack of concern about this topic. This topic not quite much being written in textbooks and there are only small trials and not much studiesthat we can cite about. Therefore, our primary aim of this review are to evaluate current knowledge relating to PPH and then make us as clinicians become more aware in detecting PPH especially in geriatric population, who are increasing in the future. So, we can diagnose earlier and treat them optimally. In this review, we will focus on epidemiology, pathophysiology, clinical manisfestations, diagnosis and management, both nonpharmacologic and pharmacologic.

Keywords: Postprandial hypotension, systolic, diastolic, elderly