Postprandial hypotension is an important clinical problem, particularly in the elderly. 5-hydroxytryptamine 3 (5-HT3) mechanisms may be important in the regulation of splanchnic blood flow, blood pressure and in mediating the effects of small intestinal nutrients on gastrointestinal motility. The aims of this study were to evaluate the effects of the 5-HT3 antagonist, granisetron, on the blood pressure (BP), heart rate (HR) and antropyloroduodenal (APD) motility responses to intraduodenal glucose in the healthy elderly. Ten subjects (5M, 5F, aged 65-76 years) received an intraduodenal glucose infusion (3 kcal/min) for 60 minutes (t = 0-60 min), followed by intraduodenal saline for a further 60 minutes (t = 60-120 min) on two days. Granisetron (10µg/kg) or control (saline) was given intravenously at t = -25 min. BP (systolic and diastolic), HR and APD pressures were measured. Pressure waves in the duodenal channel closest ('local') to the infusion site were quantified separately. During intraduodenal glucose, there were falls in systolic and diastolic BP and a rise in HR (P < 0.0001 for all); granisetron had no effect on these responses. Granisetron suppressed the number and amplitude (P < 0.05 for both) of 'local' duodenal pressures during intraduodenal glucose. Otherwise, the effects of intraduodenal glucose on APD motility did not differ between study days. We conclude that in healthy older subjects 5-HT3 mechanisms modulate the 'local' duodenal motor effects of, but not the cardiovascular responses to, small intestinal glucose.