The journal of nutrition, health & aging

, Volume 23, Issue 10, pp 1026–1033 | Cite as

Prevalence and Risk Factors of Postprandial Hypotension among Elderly People Admitted in a Geriatric Evaluation and Management Unit : An Observational Study

  • Didier SchoevaerdtsEmail author
  • M. Iacovelli
  • E. Toussaint
  • F.-X. Sibille
  • M. De Saint-Hubert
  • G. Cremer



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 words

Postprandial 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.


  1. 1.
    Luciano GL, Brennan MJ, Rothberg MB. Postprandial hypotension. Am J Med 2010;123 (3):281–286. doi: CrossRefGoogle Scholar
  2. 2.
    Samaras D, Carmona G, Vischer U, Perrenoud JJ. Postprandial hypotension: an unclear clinical entity. Rev Med Suisse 2006;2 (85):2456–2458, 2460–2451PubMedGoogle Scholar
  3. 3.
    Jansen RW, Lipsitz LA. Postprandial hypotension: epidemiology, pathophysiology, and clinical management. Ann Intern Med 1995;122 (4):286–295CrossRefGoogle Scholar
  4. 4.
    Aronow WS, Ahn C. Association of postprandial hypotension with incidence of falls, syncope, coronary events, stroke, and total mortality at 29-month follow-up in 499 older nursing home residents. J Am Geriatr Soc 1997;45 (9):1051–1053CrossRefGoogle Scholar
  5. 5.
    Fisher AA, Davis MW, Srikusalanukul W, Budge MM. Postprandial hypotension predicts all-cause mortality in older, low-level care residents. J Am Geriatr Soc 2005;53 (8):1313–1320. doi: CrossRefGoogle Scholar
  6. 6.
    Farnsworth TA, Heseltine D. The effect of postprandial hypotension on rehabilitation of the frail elderly with cerebrovascular disease. J Int Med Res 1994;22 (2):77–84. doi: CrossRefGoogle Scholar
  7. 7.
    Trahair LG, Horowitz M, Jones KL. Postprandial hypotension: a systematic review. J Am Med Dir Assoc 2014;15 (6):394–409. doi: CrossRefGoogle Scholar
  8. 8.
    Van Orshoven NP, Jansen PA, Oudejans I, Schoon Y, Oey PL. Postprandial hypotension in clinical geriatric patients and healthy elderly: prevalence related to patient selection and diagnostic criteria. J Aging Res 2010;243752. doi: CrossRefGoogle Scholar
  9. 9.
    Vloet LC, Pel-Little RE, Jansen PA, Jansen RW. High prevalence of postprandial and orthostatic hypotension among geriatric patients admitted to Dutch hospitals. J Gerontol A Biol Sci Med Sci 2005;60 (10):1271–1277CrossRefGoogle Scholar
  10. 10.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40 (5):373–383CrossRefGoogle Scholar
  11. 11.
    Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of Illness in the Aged. The Index of Adl: A Standardized Measure of Biological and Psychosocial Function. JAMA 1963;185:914–919CrossRefGoogle Scholar
  12. 12.
    Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9 (3):179–186CrossRefGoogle Scholar
  13. 13.
    Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony P, Charlton KE, Maggio M, Tsai AC, Grathwohl D, Vellas B, Sieber CC, Group MN-I. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 2009;13 (9):782–788CrossRefGoogle Scholar
  14. 14.
    Rolland Y, Lauwers-Cances V, Cournot M, Nourhashemi F, Reynish W, Riviere D, Vellas B, Grandjean H. Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. J Am Geriatr Soc 2003;51 (8):1120–1124CrossRefGoogle Scholar
  15. 15.
    Sipers WM, Verdijk LB, Sipers SJ, Schols JM, van Loon LJ. The Martin Vigorimeter Represents a Reliable and More Practical Tool Than the Jamar Dynamometer to Assess Handgrip Strength in the Geriatric Patient. J Am Med Dir Assoc 2016;17 (5):461–467. doi: CrossRefGoogle Scholar
  16. 16.
    Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39 (2):142–148CrossRefGoogle Scholar
  17. 17.
    Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49 (2):M85–94CrossRefGoogle Scholar
  18. 18.
    Cremer G, Schoevaerdts D, de Saint-Hubert M, Jamart J, Poulain G, Toussaint E, Iacovelli M, Swine C. The Get-up early test, elaboration process of a new screening tool for psychomotor disadaptation syndrome. Geriatr Psychol Neuropsychiatr Vieil 2012;10 (2):165–173. doi: PubMedGoogle Scholar
  19. 19.
    Aronow WS, Ahn C. Postprandial hypotension in 499 elderly persons in a long-term health care facility. J Am Geriatr Soc 1994;42 (9):930–932CrossRefGoogle Scholar
  20. 20.
    Abbas R, Tanguy A, Bonnet-Zamponi D, Djedid R, Lounis A, Gaubert-Dahan ML. New Simplified Screening Method for Postprandial Hypotension in Older People. J Frailty Aging 2018;7 (1):28–33. doi: PubMedGoogle Scholar
  21. 21.
    Son JT, Lee E. Postprandial hypotension among older residents of a nursing home in Korea. J Clin Nurs 2012;21 (23–24):3565–3573. doi: CrossRefGoogle Scholar
  22. 22.
    Jones KL, O’Donovan D, Russo A, Meyer JH, Stevens JE, Lei Y, Keogh J, Tonkin A, Horowitz M. Effects of drink volume and glucose load on gastric emptying and postprandial blood pressure in healthy older subjects. Am J Physiol Gastrointest Liver Physiol 2005;289 (2):G240–248. doi: CrossRefGoogle Scholar
  23. 23.
    Puisieux F, Bulckaen H, Fauchais AL, Drumez S, Salomez-Granier F, Dewailly P. Ambulatory blood pressure monitoring and postprandial hypotension in elderly persons with falls or syncopes. J Gerontol A Biol Sci Med Sci 2000;55 (9):M535–540CrossRefGoogle Scholar
  24. 24.
    Shaw BH, Borrel D, Sabbaghan K, Kum C, Yang Y, Robinovitch SN, Claydon VE. Relationships between orthostatic hypotension, frailty, falling and mortality in elderly care home residents. BMC Geriatr 2019;19 (1):80. doi: CrossRefGoogle Scholar
  25. 25.
    Asensio E, Alvarez JB, Lara S, Alvarez de la Cadena JE, Juarez D. Postprandial hypotension in the elderly: Findings in a Mexican population. Arch Cardiol Mex 85 2015;(4):284–291. doi: PubMedGoogle Scholar
  26. 26.
    Kamel HK, Iqbal MA, Malekgoudarzi B. Postprandial hypotension and relation to falls in institutionalized elderly persons. Ann Intern Med 2001;135 (4):302CrossRefGoogle Scholar
  27. 27.
    Testa G, Ceccofiglio A, Mussi C, Bellelli G, Nicosia F, Bo M, Riccio D, Curcio F, Martone AM, Noro G, Landi F, Ungar A, Abete P. Hypotensive Drugs and Syncope Due to Orthostatic Hypotension in Older Adults with Dementia (Syncope and Dementia Study). J Am Geriatr Soc 2018;66 (8):1532–1537. doi: CrossRefGoogle Scholar
  28. 28.
    Biaggioni I. Orthostatic Hypotension in the Hypertensive Patient. Am J Hypertens 31 (12):1255–1259. doi: CrossRefGoogle Scholar
  29. 29.
    Kaplan SA, Chughtai BI. Safety of Tamsulosin: A Systematic Review of Randomized Trials with a Focus on Women and Children. Drug Saf 2018;41 (9):835–842. doi: CrossRefGoogle Scholar
  30. 30.
    Costa P. Benign hypertrophy of the prostate (BHP) in France: a challenge in organization of care. Ann Urol (Paris) 2006;40 Spec No 1:1–3CrossRefGoogle Scholar
  31. 31.
    Barochiner J, Alfie J, Aparicio LS, Cuffaro PE, Rada MA, Morales MS, Galarza CR, Marin MJ, Waisman GD. Postprandial hypotension detected through home blood pressure monitoring: a frequent phenomenon in elderly hypertensive patients. Hypertens Res 2014;37 (5):438–443. doi: CrossRefGoogle Scholar
  32. 32.
    Fisher AA, McLean AJ, Davis MW, Le Couteur DG. A multicenter, case-control study of the effects of antihypertensive therapy on orthostatic hypotension, postprandial hypotension, and falls in octo- and nonagenarians in residential care facilities. Curr Ther Res Clin Exp 2003;64 (3):206–214. doi: CrossRefGoogle Scholar
  33. 33.
    Tabara Y, Okada Y, Uetani E, Nagai T, Igase M, Kido T, Ochi N, Ohara M, Takita R, Kohara K, Miki T. Postprandial hypotension as a risk marker for asymptomatic lacunar infarction. J Hypertens 2014;32 (5):1084–1090; discussion 1090. doi: CrossRefGoogle Scholar
  34. 34.
    Deguchi K, Ikeda K, Sasaki I, Shimamura M, Urai Y, Tsukaguchi M, Touge T, Takeuchi H, Kuriyama S. Effects of daily water drinking on orthostatic and postprandial hypotension in patients with multiple system atrophy. J Neurol 2007;254 (6):735–740. doi: CrossRefGoogle Scholar
  35. 35.
    Trahair LG, Horowitz M, Jones KL. Postprandial hypotension is associated with more rapid gastric emptying in healthy older individuals. J Am Med Dir Assoc 2015;16 (6):521–523. doi: CrossRefGoogle Scholar

Copyright information

© Serdi and Springer-Verlag International SAS, part of Springer Nature 2019

Authors and Affiliations

  • Didier Schoevaerdts
    • 1
    • 3
    Email author
  • M. Iacovelli
    • 2
  • E. Toussaint
    • 2
  • F.-X. Sibille
    • 1
  • M. De Saint-Hubert
    • 1
  • G. Cremer
    • 2
  1. 1.Department of Geriatric Medicine, Mont-Godinne University Medical Center, CHU UCL Namur-Godinne SiteCatholic University of Louvain (UCL) and Institute of Health and Society (IRSS-UCL)LouvainBelgium
  2. 2.Department of Physiotherapy, Mont-Godinne University Medical CenterCatholic University of Louvain (UCL)LouvainBelgium
  3. 3.CHU UCL Namur, site GodinneYvoirBelgium

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