Abstract 19645: Marked Improvement of Postprandial Hypotension by Xanthine Derivatives and Preparations
Introduction: Postprandial hypotension (PPH) is an important and frequent problem, particularly in the elderly. Several studies have suggested that caffeine, acarbose, DL-DOPS, Guar gum and octreotide can improve postprandial symptoms and result in reduction in postprandial blood pressure (BP). However, these treatments may not necessarily be effective in the patients with symptomatic PPH.
Hypothesis: In the present study, we sought to determine whether Xanthine derivatives and preparations, an adenosine antagonist same as caffeine which block splanchnic methylxantine-sensitive adenosine receptors could be effective for PPH showing resistance to other treatments.
Methods: 74-year-old man under outpatient care for hypertension was admitted to Aoyama Hospital, Tokyo Women’s Medical University, Tokyo, Japan, for the investigation and treatment of syncope after breakfast in June 2014. Ambulatory BP monitoring (ABPM) over a 24 hours period showed a decrease in systolic BP of more than 20 mmHg within 2 hours after meal, leading to the diagnosis of PPH. We examined meal terrace test (high carbohydrate meal; 60-70g) using ABPM, the patient settled supine position during 2 hours after eating. We investigated and compared the effects of voglibose (0.6mg/day), Guar gum, and theophylline (400mg/day) by ABPM.
Results: Having only the meal, BP decreased from 149/63 to 85/46mmHg at 30 minutes after eating. Similar results were observed with administration of voglibose and Guar gum (BP: from 121/79 to 74/51mmHg, from 121/63 to 89/55mmHg, respectively). Surprisingly, theophylline treatment resulted in a smaller reduction in BP at 30 minutes (BP from 124/68 to 117/68mmHg) and within 2 hours after eating (minimum BP 107/71 mmHg).
Conclusions: This is the first report of improvement of postprandial hypotension by xanthine derivatives and preparations. It is suggested that theophylline may be an alternative effective treatment for postprandial hypotension in the elderly.
Author Disclosures: H. Sekiguchi: None. F. Tatsumi: None. Y. Manaka: None. Y. Tanaka: None. M. Kimura: None. E. Watanabe: None. K. Shimamoto: None. M. Kawana: None.
- © 2014 by American Heart Association, Inc.