Frequency and importance of postprandial blood pressure reduction in elderly nursing-home patients
Article Abstract:
The autonomic nervous system adjusts the function of many systems of the body to changing needs. A common contrast is the physiological needs brought on by physical exertion and the physiological requirements of digesting a large meal. In some patients, these autonomic adjustments may be abnormal. For example, in young people with autonomic insufficiency, the blood pressure may drop significantly after a meal. This hypotension can be severe enough to cause fainting. Similarly, older patients with a history of fainting have been shown to have substantial drops in blood pressure following a meal. Several studies have been conducted to measure hypotension in nursing home patients following meals, but the rigorous testing environments of these studies may not effectively represent the normal responses of the patients. A study has been conducted to evaluate the blood pressure of nursing home patients in an unobtrusive manner which disrupts only minimally the normal daily routine of the patients. The subjects for this study were 113 volunteer nursing home residents. Of these, 109 developed a reduction in blood pressure within 75 minutes after consuming a standardized meal. The average reduction of systolic (peak) blood pressure was 18 millimeters of mercury (mm Hg). In 41 patients, the reduction exceeded 20 mm Hg. In 12 patients, this reduction carried the systolic blood pressure below 100 mm Hg, indicating significant hypotension, and two of the 12 patients experienced acute symptoms of hypotension. One of these patients experienced chest pain and the other had right-side weakness and indications of a transient ischemic attack (TIA), in which portions of the brain are not receiving enough oxygen. The diastolic blood pressure, the low point in the blood pressure which occurs as the heart ventricles are relaxing, did not change appreciably following the meal. During the follow-up period, which averaged six months, 14 of the patients in this study died. However, no correlation was found between the reduction in blood pressure after meals and the risk of death. The results of this study indicate that hypotension following meals is quite common among nursing home residents, and that this reduction in blood pressure is large for many patients. This postprandial hypotension, however, does not seem to indicate any increased risk of mortality. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1991
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How long should blood thinners be given to patients who have had a pulmonary embolism?
Article Abstract:
People who have had a pulmonary embolism and have risk factors for a recurrence should probably take an anticoagulant for the rest of their lives, according to a study of 326 patients. Pulmonary embolism occurs when a blood clot forms in the leg and then travels to the lungs. It is a very serious condition and can even be fatal. In this study, some patients took an anticoagulant for a year but their risk of pulmonary embolism increased again once they stopped taking the drug.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 2003
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