Prevalence of and risk factors for postprandial hypotension in older Chinese men

OBJECTIVE To assess the prevalence of and risk factors for postprandial hypotension (PPH) among old and very old Chinese men. METHODS The study included 349 Chinese men aged 65 and older, grouped into two age categories: group 1 (old) included 163 men aged 65 to 80 years; group 2 (very old) included 186 men aged over 80 years. Blood pressure changes after meals were assessed every 15 min by ambulatory blood pressure monitoring. Symptoms after meal ingestion and after standing up and changes in the baseline condition relative to blood pressure changes were observed continuously. Additional baseline data included body mass index, medical history, and medication use. RESULTS The prevalence of PPH was 59.3% overall and was significantly higher in group 2 than group 1 (63.4% vs. 54.6%, P < 0.05). In group 2, the prevalence of PPH after breakfast (33.8%) and lunch (32.1%) were higher than that after supper (20.9%), P < 0.05. Hypertension and age were significant risk factors for PPH (OR = 2.188, 95% CI: 1.134-4.223, P = 0.02; OR = 1.86, 95% CI: 1.112-3.11, P = 0.018, respectively). In contrast, acarbose use was protective against PPH (OR = 0.4, 95% CI: 0.189-0.847, P = 0.017). The decrease in blood pressure during PPH was 20-40 mmHg and the maximum was 90 mmHg. PPH usually occurred at 30-60 min after a meal and lasted 30-120 min. CONCLUSIONS These findings demonstrate that the prevalence of PPH in men aged over 80 years is significantly higher than those in men aged 65 to 80 years, and the blood pressure decline is also higher for men aged over 80 years. In addition, hypertension and age were main risk factors for PPH in the older men, which suggest that preventing and treating PPH is worthwhile.