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

ABSTRACT

OBJECTIVES: To explore the prevalence and potential risk factors of postprandial hypotension (PPH) among elderly patients in an acute geriatric ward. DESIGN: A prospective observational study. SETTING: Geriatric Unit in a Belgian tertiary-care University Hospital. PARTICIPANTS: Seventy-six hospitalized elderly patients after stabilization of their acute conditions. MEASUREMENTS 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. RESULTS: 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. CONCLUSION: 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.