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Postprandial hypotension common in diabetics

15 Oct 2020

Postprandial hypotension (PPH) is common among diabetic patients and is tied to high systolic blood pressure (SBP) before meals, a new study has found.

The study included 300 diabetes patients (median age, 70 years) who were asked to measure their blood pressure at six points: just before and just after a meal, and 30, 60, 90, and 120 minutes after the main meal of the day. PPH was defined as an SBP decrease of ≥20 mm Hg relative to the pre-meal blood pressure within 2 hours after the meal.

Fifty percent (n=150) of the participants were positive for PPH, of whom only 15 experienced associated symptoms. Age, glycated haemoglobin, and pre-meal SBP were all elevated in PPH patients.

Multiple logistic regression analysis revealed that higher SBP measurements before a meal significantly increased the risk of PPH by over 50 percent (odds ratio [OR], 1.56, 95 percent confidence interval [CI], 1.30–1.86; p<0.001). This was also true, and even stronger, in the subgroup of patients who were not on antihypertensive medication (OR, 13.02, 95 percent CI, 1.63–103.93; p=0.012).

In another sub-analysis, the researchers found that age, glycated haemoglobin levels, and the coefficients of variation of R-R intervals were all likewise significant correlates asymptomatic PPH.

“Patients with diabetes need to be monitored for hypertension to prevent development of complications and PPH,” the researchers said. “Furthermore, treatment of older adults with diabetes, patients with uncontrolled diabetes, or diabetes-related autonomic nervous system disorders should include PPH monitoring, even when subjective symptoms have not been reported.”

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Most Read Articles
Pearl Toh, 22 Oct 2020
The combination therapy comprising carfilzomib, cyclophosphamide and dexamethasone (KCd) is effective, with a tolerable safety profile, in an Asian cohort with high-risk multiple myeloma (MM) — thus providing a more economical alternative as a potential upfront regimen in resource-limited settings, according to leading experts during a myeloma education webinar.
Roshini Claire Anthony, 13 Nov 2020

Diabetes is a key risk factor for heart failure (HF), which is the leading cause of hospitalization in patients with or without diabetes. SGLT-2* inhibitors (SGLT-2is) have been shown to reduce the risk of hospitalization for HF (HHF) regardless of the presence or absence of diabetes.

Pearl Toh, 5 days ago
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Elvira Manzano, 17 Nov 2020
Invasive fungal infections, particularly those caused by Candida species, are common in hospitalized, immunocompromised, or critically ill patients and are associated with considerable morbidity and mortality.