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Baroreflex function and postprandial hypotension in older adults

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Abstract

Purpose

Postprandial hypotension (PPH) is a common but poorly understood etiology for fainting in older adults. One potential mechanism is age-related baroreflex dysfunction. We examined baroreflex function in older adults with PPH and without PPH (noPPH) during a standardized meal test.

Methods

57 adults (age ≥ 65; 24 PPH, 33 noPPH, mean age 77.9 ± 0.9 years, 54% female) were recruited and had meal tests performed. The baroreflex effectiveness index (BEI, %) and baroreflex sensitivity (BRS, ms/mm Hg) were calculated using the sequence method.

Results

Baseline BEI (22 ± 2 versus 23 ± 2 percent, t = − 0.411, p = 0.682) and BRS (14.1 ± 2.4 versus 13.8 ± 2.5 ms/mm of Hg, t = − 0.084, p = 0.933) were similar in PPH and noPPH subjects. During the meal test PPH subjects showed significantly lower BEI as compared to noPPH subjects (time × PPH, F = 2.791, p = 0.042), while there was no difference in the postprandial change in BRS (time, F = 0.618, p = 0.605).

Conclusion

Patients with PPH demonstrated an acute postprandial decrease in baroreflex effectiveness during meal testing as compared with normal subjects, suggesting a potential contributing mechanism for this condition.

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Acknowledgements

This work was supported by the Allan M. McGavin Foundation and the Heart and Stroke Foundation of Canada (G-13-0001812).

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Authors and Affiliations

  1. Gerontology and Diabetes Research Laboratory, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada

    Kenneth M. Madden, Boris Feldman & Graydon S. Meneilly

  2. Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada

    Kenneth M. Madden

  3. Allan M. McGavin Chair in Geriatric Medicine, Room 7185, Gordon and Leslie Diamond Health Care Centre, 2775 Laurel St., Vancouver, BC, V5Z 1M9, Canada

    Kenneth M. Madden

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  1. Kenneth M. Madden
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Correspondence to Kenneth M. Madden.

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Madden, K.M., Feldman, B. & Meneilly, G.S. Baroreflex function and postprandial hypotension in older adults. Clin Auton Res 31, 273–280 (2021). https://doi.org/10.1007/s10286-020-00671-8

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  • DOI: https://doi.org/10.1007/s10286-020-00671-8

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