Our clinical research group is interested in the mechanisms associated with falls in blood pressure after meals—as experienced by the elderly.
Postprandial hypotension (PPH) is an important disorder characterised by a fall in blood pressure after meals. PPH has received little attention, despite being one of the main causes of fall-related injuries in Australia and the fact that injury prevention remains a National Health Priority Area.
PPH occurs in around 20% of the healthy elderly, and in more than 40% of nursing home residents and patients with longstanding type 1 or 2 diabetes. It adversely affects quality of life, particularly because fainting leads to falls, stroke, and angina—as well as increased mortality. Management of PPH is currently suboptimal, at least in part because the condition has been poorly defined.
A postprandial fall in blood pressure indicates that there is inadequate cardiovascular compensation for blood pooling in the gut as a result of the person eating a meal. But other factors may be involved in PPH, such as the rate of small intestinal nutrient delivery, gastric distension, release of gastrointestinal hormones and changes in nerve function and gut blood flow.
Research by the Postprandial Hypotension Group and others has shown that the fall in blood pressure is related to the rate of nutrient delivery from the stomach into the small intestine. This research has led to fundamental changes to the management of patients with diabetes and postprandial hypotension. Our studies have established the pivotal role of gastric emptying in postprandial glycaemia and the impact of variations in blood glucose on gastrointestinal symptoms.
Our continuing research is focused on translating these recent insights relating to the causes of PPH. We aim to implement specific and effective management strategies to improve health outcomes.
Lead researcher: Professor Karen Jones
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