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1 Department of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide, SA, Australia
2 Department of Clinical Pharmacology, University of Adelaide, Royal Adelaide Hospital, Adelaide, SA, Australia
* To whom correspondence should be addressed. E-mail: karen.jones{at}adelaide.edu.au.
Postprandial hypotension (PPH) occurs frequently in the elderly; the magnitude of the fall in blood pressure (BP) is related to the rate of glucose entry into the duodenum during intraduodenal glucose infusion and spontaneous gastric emptying (GE). It is unclear if glucose concentration affects the hypotensive response. Gastric distension may attenuate PPH, therefore, meal volume could influence the BP response. We aimed to determine the effects of (i) drink volume, (ii) glucose concentration, and (iii) glucose content on the BP and heart rate (HR) responses to oral glucose. Ten subjects (73.9 ± 1.2yr) had measurements of BP, GE and blood glucose on 4 days after: (i) 25g glucose in 200ml (12.5%) (ii) 75g glucose in 200ml (37.5%), (iii) 25g glucose in 600ml (4%) and (iv) 75g glucose in 600ml (12.5%). GE, BP and HR and blood glucose were measured for 180min. After all drinks, duodenal glucose loads were similar in the first 60min. Regardless of concentration, 600ml (but not 200ml) drinks initially increased BP; and in the first 30min, systolic BP correlated (P<0.01) with volume in both the proximal and total stomach. At the same concentration (12.5%) systolic BP fell more (P=0.02) at the smaller volume; at the same volumes, there were no effects of concentration on BP. There was no difference in the glycemic response to drinks of identical glucose content. We conclude that (i) ingestion of glucose at a higher volume attenuates, and (ii) under constant duodenal load, glucose concentration (4%-37%), does not affect, the fall in BP.
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