Prevalence and Risk Factors of Postprandial Hypotension among Elderly People Admitted in a Geriatric Evaluation and Management Unit : An Observational Study
To explore the prevalence and potential risk factors of postprandial hypotension (PPH) among elderly patients in an acute geriatric ward.
A prospective observational study.
Geriatric Unit in a Belgian tertiary-care University Hospital.
Seventy-six hospitalized elderly patients after stabilization of their acute conditions.
PPH and orthostatic hypotension (OH) measured by a non-invasive automated blood pressure device, demographic data, Katz’s Basic Activities of Daily Living (ADL) and Lawton’s instrumental ADL, Short Physical Performance Battery, Charlson Comorbidity Index, Mini Nutritional Assessment-Short Form, Timed Up and Go test, Get-up Early test, grip strength and 7 classes of drugs.
Overall, the prevalence of PPH was 46% (n=35/76), and it was symptomatic in 31% of the patients (n=11/35). PPH is associated with OH in one-third of the cases (n=12/35). Two-thirds of the patients with HPP had a significant drop in systolic blood pressure within the first 75 minutes after a meal. In univariate analyses, risk factors of PPH were nursing home residence, alpha-blocker consumption, help needed for eating and a good level of global functional status. However, patients with a good functional status were at increased risk of alpha-blocker exposure. In multivariate analyses, only alpha-blocker consumption and help needed for eating remained statistically significant.
PPH is frequent among hospitalized elderly people in a Geriatric Evaluation and Management Unit, affecting nearly one out of two people. The use of alpha-blockers is an important risk factor and may alert clinicians to the risk of PPH.
Key wordsPostprandial hypotension elderly orthostatic hypotension risk factors epidemiology
The authors thank the Master’s students from the Faculty of Motor Sciences, UCLouvain, who helped in collecting data and performing blood pressure tests during their stay in the geriatric ward: Armand Dubuy, Jean-Baptiste Dorandeu, Gaelle Brackelaire and Esther Boland. They also thank the dietetic department at CHU UCL Namur, Godinne site, for their contribution in collecting meal data: Mégane Ruth, Alexandra Ernst de la Graete and Amandine Degroot.
Ethical standards: All participants or their legal representatives were required to sign written informed consent forms. The study protocol was approved by the Local Ethics Committee of the CHU UCL Namur (NUB: B039201628238). The experiment complies with the current Belgian Law of Human Experiments of the seventh of May 2004.
Conflict of interest: The authors declare that they have no conflict of interest. No specific funding was used for the study.
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