Effect of blood insulin level on postprandial hypotension in elderly people.
Journal
Blood pressure monitoring
ISSN: 1473-5725
Titre abrégé: Blood Press Monit
Pays: England
ID NLM: 9606438
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
pubmed:
15
5
2020
medline:
15
12
2020
entrez:
15
5
2020
Statut:
ppublish
Résumé
The aim of the study is to discuss the effect of postprandial insulin level on blood pressure in elderly patients by comparing the blood pressure, blood glucose, and insulin levels between patients with postprandial hypotension (PPH) and non-PPH over 80 years old during fasting and within 2 h after meal, and observing the changes of parameters in patients with PPH before and after treatment with acarbose. Twenty-five PPH patients and 27 non-PPH patients were selected. The blood pressure, blood glucose, and insulin levels during fasting and within 2 h after meal were monitored. Patients with PPH were treated with acarbose. All parameters were checked one week later. (1) Preprandial blood pressure in PPH group was significantly higher than that in non-PPH group (152.00 ± 15.62 mmHg vs. 136.40 ± 14.12 mmHg, P < 0.05). (2) The maximum decrease of postprandial systolic blood pressure (SBP) in PPH group was significantly increased compared with that of the control group (32.20 ± 13.19 mmHg vs. 9.67 ± 8.38 mmHg, P < 0.05). The maximum increases of postprandial blood glucose and insulin levels were significantly higher in PPH group than in the control group (P < 0.05). (3) After acarbose treatment, the decrease of postprandial SBP in PPH group was significantly reduced compared with that before treatment (22.67 ± 6.98 mmHg vs. 32.60 ± 9.55 mmHg, P < 0.05); the increase of postprandial blood glucose was also significantly reduced in PPH group (2.37 ± 1.63 mmol/L vs. 3.39 ± 1.62 mmol/L, P < 0.05); the increase of postprandial insulin level was reduced significantly in PPH group (12.09 ± 3.96 mU/L vs. 22.33 ± 1.78 mU/L, P < 0.05). (4) There was no correlation between the maximum decrease of postprandial SBP and the maximum increase of blood glucose (r = -0.008, P = 0.961), but the maximum decrease of postprandial SBP was positively correlated with the maximum increase of insulin (r = 0.381, P = 0.032). PPH tends to occur in elderly people with elevated basal blood pressure before meal. PPH is associated with an abnormal increase of postprandial insulin secretion. Reducing the increase of postprandial insulin is one of the mechanisms of acarbose in the treatment of PPH.
Identifiants
pubmed: 32404599
doi: 10.1097/MBP.0000000000000450
pii: 00126097-202008000-00005
doi:
Substances chimiques
Blood Glucose
0
Insulins
0
Acarbose
T58MSI464G
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
201-205Références
Trahair LG, Vanis L, Gentilcore D, Lange K, Rayner CK, Horowitz M, Jones KL. Effects of variations in duodenal glucose load on blood pressure, heart rate, superior mesenteric artery blood flow and plasma noradrenaline in healthy young and older subjects. Clin Sci (Lond). 2012; 122:271–279
Masuda Y, Kawamura A. Role of the autonomic nervous system in postprandial hypotension in elderly persons. J Cardiovasc Pharmacol. 2003; 42Suppl 1S23–S26
Maruta T, Komai K, Takamori M, Yamada M. Voglibose inhibits postprandial hypotension in neurologic disorders and elderly people. Neurology. 2006; 66:1432–1434
Trahair LG, Horowitz M, Hausken T, Feinle-Bisset C, Rayner CK, Jones KL. Effects of exogenous glucagon-like peptide-1 on the blood pressure, heart rate, mesenteric blood flow, and glycemic responses to intraduodenal glucose in healthy older subjects. J Clin Endocrinol Metab. 2014; 99:E2628–E2634
Fukushima T, Asahina M, Fujinuma Y, Yamanaka Y, Katagiri A, Mori M, Kuwabara S. Role of intestinal peptides and the autonomic nervous system in postprandial hypotension in patients with multiple system atrophy. J Neurol. 2013; 260:475–483
Soe K, Sacerdote A, Karam J, Bahtiyar G. Management of type 2 diabetes mellitus in the elderly. Maturitas. 2011; 70:151–159
Barochiner J, Alfie J, Aparicio LS, Cuffaro PE, Rada MA, Morales MS, et al. Postprandial hypotension detected through home blood pressure monitoring: a frequent phenomenon in elderly hypertensive patients. Hypertens Res. 2014; 37:438–443
Son JT, Lee E. Postprandial hypotension among older residents of a nursing home in Korea. J Clin Nurs. 2012; 21:3565–3573
Zanasi A, Tincani E, Evandri V, Giovanardi P, Bertolotti M, Rioli G. Meal-induced blood pressure variation and cardiovascular mortality in ambulatory hypertensive elderly patients: preliminary results. J Hypertens. 2012; 30:2125–2132
Zou X, Cao J, Li JH, Hu YX, Guo YS, Si QJ, Fan L. Prevalence of and risk factors for postprandial hypotension in older Chinese men. J Geriatr Cardiol. 2015; 12:600–604
Fisher AA, Davis MW, Srikusalanukul W, Budge MM. Postprandial hypotension predicts all-cause mortality in older, low-level care residents. J Am Geriatr Soc. 2005; 53:1313–1320
Son JT, Lee E. Prevalence and risk factors of postprandial hypotension in Korean elderly people. J Korean Acad Nurs. 2009; 39:198–206
Zhang YN, Chen TL, Geng X, Gu GQ, Zheng HM, Yang XH, et al. Clinical observation of postprandial hypotension in patients with hypertensive and coronary heart disease. Zhonghua Yi Xue Za Zhi. 2018; 98:2641–2644
Vanis L, Gentilcore D, Rayner CK, Wishart JM, Horowitz M, Feinle-Bisset C, Jones KL. Effects of small intestinal glucose load on blood pressure, splanchnic blood flow, glycemia, and GLP-1 release in healthy older subjects. Am J Physiol Regul Integr Comp Physiol. 2011; 300:R1524–R1531
Mathias CJ, da Costa DF, Fosbraey P, Christensen NJ, Bannister R. Hypotensive and sedative effects of insulin in autonomic failure. Br Med J (Clin Res Ed). 1987; 295:161–163
Brown RT, Polinsky RJ, Lee GK, Deeter JA. Insulin-induced hypotension and neurogenic orthostatic hypotension. Neurology. 1986; 36:1402–1406
Takata S, Yamamoto M, Yagi S, Noto Y, Ikeda T, Hattori N. Peripheral circulatory effects of insulin in diabetes. Angiology. 1985; 36:110–115
Visvanathan R, Chen R, Garcia M, Horowitz M, Chapman I. The effects of drinks made from simple sugars on blood pressure in healthy older people. Br J Nutr. 2005; 93:575–579
Jansen RW, Peeters TL, Lenders JW, van Lier HJ, v’t Laar A, Hoefnagels WH. Somatostatin analog octreotide (SMS 201-995) prevents the decrease in blood pressure after oral glucose loading in the elderly. J Clin Endocrinol Metab. 1989; 68:752–756
Scherrer U, Randin D, Vollenweider P, Vollenweider L, Nicod P. Nitric oxide release accounts for insulin’s vascular effects in humans. J Clin Invest. 1994; 94:2511–2515
Steinberg HO, Brechtel G, Johnson A, Fineberg N, Baron AD. Insulin-mediated skeletal muscle vasodilation is nitric oxide dependent. A novel action of insulin to increase nitric oxide release. J Clin Invest. 1994; 94:1172–1179
Shibao C, Gamboa A, Diedrich A, Dossett C, Choi L, Farley G, Biaggioni I. Acarbose, an alpha-glucosidase inhibitor, attenuates postprandial hypotension in autonomic failure. Hypertension. 2007; 50:54–61
Qiao W, Li J, Li Y, Qian D, Chen L, Wei X, et al. Acarbose, the α-glucosidase inhibitor, attenuates the blood pressure and splanchnic blood flow responses to meal in elderly patients with postprandial hypotension concomitant with abnormal glucose metabolism. Blood Press Monit. 2016; 21:38–42