Asymptomatic postprandial hypotension in patients with diabetes: The KAMOGAWA-HBP study.

INTRODUCTION Postprandial hypotension (PPH) refers to a decrease in systolic blood pressure (SBP) by ≥20 mmHg or to <90 mmHg from baseline ≥100 mmHg within 2 hours of a meal. Previous studies have reported an association between diabetes and PPH; however, the characteristics of PPH in patients with diabetes remain unclear. MATERIALS AND METHODS We recruited patients with diabetes who regularly attended the diabetes outpatient clinic. Participants were instructed to perform 3 sets of blood pressure measurements at 6 time points: just before and just after, and 30, 60, 90, and 120 minutes after their main meal of the day. Data on PPH symptoms were collected during an interview. To investigate the relationships between explanatory variables, PPH, and associated symptoms, we performed multiple logistic regression analyses. RESULTS We analyzed data from 300 participants. There were 150 (50.0%) participants with PPH. SBP before meal was significantly associated with PPH (odds ratio [OR]=1.56, 95% confidence interval [CI]: 1.30-1.86, p<0.001), after adjusting for covariates. Furthermore, age (OR=1.08, 95% CI: 1.01-1.16, p=0.027), hemoglobin A1c level (OR=2.39, 95% CI: 1.01-5.64, p=0.030), and coefficients of variation of R-R intervals (OR=0.79, 95% CI: 0.65-0.97, p=0.032) were significantly associated with asymptomatic PPH. CONCLUSIONS Half of the present study outpatients with diabetes had PPH. High SBP before meal was significantly associated with the risk of PPH. Older adults and patients with higher levels of hemoglobin A1c or an autonomic dysfunction might have difficulties recognizing symptoms of PPH.