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Blood pressure measurement and the prevalence of postprandial hypotension
Kenneth M Madden1, Boris Feldman, Graydon S Meneilly
1Gerontology and Diabetes Research Laboratory, Division of Geriatric Medicine, Department of Medicine and Centre for Hip Health and Mobility, University of British Columbia, Vancouver BC. Kenneth.Madden@mail.ubc.ca.
Background:
Postprandial hypotension (PPH) is a serious condition that has been shown to be an independent risk factor for falls, fractures and death.
Purpose:
The prevalence of this problem in older adults with a past history of falls has shown a wide variability in the literature; the present study seeks to examine how the frequency with which blood pressure is measured impacts the prevalence and severity of PPH.
Methods:
Older adults were recruited sequentially from a geriatric medicine falls clinic for meal testing (n=95). All subjects (mean age 77.5±0.7 years, 61±5% female) were fasting prior to each 90 min standardized meal test. A Finometer (Finapres Medical Systems BV) was used to monitor blood pressure. Beat-by-beat systolic (SBP) measures were averaged for 0.5, 1, 2, 3, 5, 6, 9, 10, 15, 18, 30, 45 and 90 min respectively during the meal test.
Results:
Using the original diagnostic method of checking mean blood pressure every 10 min resulted in a PPH prevalence of 42.1±5.1% in our population, with an overall range from 81.1±4.0% to 11.6±3.3% depending on the frequency of calculating SBP. The maximal observed postprandial decrease in SBP also showed a significant difference with blood pressure measurement frequency (p.
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