Postprandial Hypotension - Causes, Symptoms, and Treatment

Introduction

Postprandial hypotension is a condition that refers to the dropping of blood pressure after eating a meal. The term postprandial refers to the time right after a meal, and the hypotension term denotes the decrease in blood pressure. The blood pressure will change during various actions performed day and night. It is observed that postprandial hypotension is common in adults and may lead to complications. However, postprandial hypotension is observed very rarely among adults. Symptoms of postprandial hypotension include dizziness and fainting after a meal. The early diagnosis of postprandial hypotension is made, and simple lifestyle modifications are made to avoid the risk of postprandial hypotension.

What Is Postprandial Hypotension?

Postprandial hypotension is most commonly observed in adults, characterized as a decrease in the systolic blood pressure of about 20mmHg after two hours of a meal. Postprandial hypotension is a milder condition, and no factors will trigger the symptoms of postprandial hypotension. Postprandial hypotension is one form of orthostatic hypotension. Orthostatic hypertension refers to the dropping of blood pressure while standing. The cause of postprandial hypotension is the decrease of blood in general circulation due to the pooling of blood in the abdominal organs during digestion. There is no specific treatment available to treat postprandial hypotension. However, some diet modifications can be done to make digestion easier.

What Causes Postprandial Hypotension?

The exact cause for postprandial hypotension is unknown, but it is suggested to be increased blood pooling during digestion in the abdominal organs. The decrease of blood due to pooling will cause a reduction in general blood circulation. Hypotension results from poor general blood circulation—the blood supply increases when there is a constriction of blood flow in the intestines. Blood pooling in the intestines will decrease the blood circulation in the arteries, and hypotension results. In addition, postprandial hypotension is caused by various causes. Some of the suggested reasons for postprandial hypotension are mentioned below:

• High carbohydrate diet.

• Age factor.

• Impairment in the autonomic nervous system.

• Parkinson's disease.

• Diabetes condition.

• Fast absorption of glucose.

• Idiopathic.

• Severe infections.

• Uncontrolled bleeding.

• Allergic reactions.

• Other possible causes of hypotension include disease in the heart valve, severe dehydration, pregnancy, vitamin B12 deficiency, and thyroid-related disorders.

What Are the Symptoms of Postprandial Hypotension?

The primary symptoms of postprandial hypotension include dizziness, fainting, and lightheadedness after a meal. Syncope results due to a fall in blood pressure after eating. Some other symptoms of postprandial hypotension are mentioned below:

• Dizziness.

• Blurred vision.

• Feeling weak.

• Confusion.

• Fainting or feeling faint.

• Fading vision.

• Fatigue.

• Trouble concentrating.

Who Is at Risk of Postprandial Hypotension?

Postprandial hypotension is more common in adults, and young people are rarely affected by postprandial hypotension. However, some risk factors will increase people's chances of postprandial hypotension. The risk factors of postprandial hypotension are mentioned below:

• Age factor, older people are highly susceptible to postprandial hypotension.

• Medical conditions.

• People with Parkinson's disease.

• Diabetic patients.

• Hypertensive patients under antihypertensive medication will sometimes show a decrease in blood pressure causing postprandial hypotension.

• Drug actions.

What Are the Complications of Postprandial Hypotension?

Fainting is a severe complication of postprandial hypotension. During fainting, people will get injuries during falls causing fractures, bruises, and other trauma. Stroke results when the blood flow to the brain is reduced. Some of the complications of postprandial hypotension are given below:

• Fainting.

• Syncope.

• Stroke.

• Heart attack.

• Heart failure.

• Atrial fibrillation.

• Chest pain.

• Chronic kidney failure.

• Fracture.

• Shock- a life-threatening condition.

What Is the Diagnosis of Postprandial Hypotension?

The diagnosis of postprandial hypotension is based on the patient's medical history and symptoms. The blood pressure is examined, and the previous blood pressure records are evaluated. The blood pressure comparison is made between preprandial and postprandial meals. The various diagnostic tools for the diagnosis of postprandial hypotension are given below:

• Medical history of the patient.

• History of symptoms.

• Blood pressure is taken, which includes both preprandial and postprandial blood pressure values.

• Blood investigations to rule out anemia and hypoglycemia.

• Electrocardiogram and heart rhythm are checked.

• Echocardiogram, the structure, and the function of the heart are evaluated.

What Is the Treatment of Postprandial Hypotension?

The treatment is mainly done to avoid postprandial hypotension. Medications and lifestyle management are done to prevent the risk of postprandial hypotension. People taking antihypertensives can limit the dosage of drugs to avoid the chance of postprandial hypotension. In ordinary people with postprandial hypotension, lifestyle modifications are done to prevent postprandial hypotension. Some treatments and management for people with postprandial hypotension are mentioned below.

• Limiting the dose in hypertensives.

• Avoid the intake of high carbohydrate-containing foods in a meal.

• Walking after a meal.

• The application of non-steroidal anti-inflammatory drugs (NSAIDs) will increase blood pressure.

• Drinking caffeine-containing beverages such as coffee.

• Drinking plenty of water before a meal will reduce postprandial hypotension.

• Application of Sandostatin in case of increased growth hormone.

Management of postprandial hypotension involves the following methods:

• Eat small meals, and the number of meals can be increased.

• Always avoid high carbohydrate-containing foods like bread, potatoes, and pasta.

• Always avoid the consumption of alcohol.

• In severe symptoms, always stay seated.

• Exercise will diminish the symptoms of postprandial hypotension.

• People with diastolic heart failure can be treated with diuretics.

• Subcutaneous injection of octreotide acts like the pancreatic hormone somatostatin.

• Drink plenty of water.

• Drink potassium-rich fluids.

• Salt intake can be increased.

• Low-carb foods like eggs, avocado, nuts, broccoli, cauliflower, green leafy vegetables, fish, and cucumber can be taken.

Conclusion

Postprandial hypotension is a condition that occurs due to a decrease in blood pressure after a meal, thereby causing fainting, lightheadedness, and dizziness. Postprandial hypotension is common in adults and people with an impaired autonomic nervous system. Some medical conditions like Parkinson's and diabetes will aggravate the condition. Some of the complications of postprandial hypotension include fainting and injuries. There is no specific treatment available to treat postprandial hypotension. Medications and lifestyle modifications are done to manage the condition. Avoiding alcohol and high carbohydrate-containing foods will reduce the symptoms. Eating small meals, drinking plenty of water, and exercising will prevent the complications of postprandial hypotension.