[Dysphagia] post prandial hypotension

[bonnieh4455 at sbcglobal.net (Bonnie Heintskill)]

I had to look this one up so here is what I found at Merck's Manual on line

Postprandial hypotension is an excessive decrease in blood pressure that 
occurs after a meal.


  a.. Dizziness, light-headedness, and falls may occur.
  b.. Doctors measure blood pressure before and after a meal to diagnose 
postprandial hypertension.
  c.. Eating small, low-carbohydrate meals frequently may help.

Postprandial hypotension occurs in up to one third of older people but 
virtually never occurs in younger people. It is more likely to occur in 
people who have high blood pressure or disorders that impair the brain 
centers controlling the autonomic nervous system (which regulates internal 
body processes). Examples of such disorders are Parkinson's disease, 
multiple system atrophy (Shy-Drager syndrome), and diabetes.

The intestine requires a large amount of blood for digestion. When blood 
flows to the intestine after a meal, the heart rate increases and blood 
vessels in other parts of the body constrict to help maintain blood 
pressure. However, in some older people, such mechanisms may be inadequate. 
Blood flows normally to the intestine, but the heart rate does not increase 
adequately and blood vessels do not constrict enough to maintain blood 
pressure. As a result, blood pressure falls.

Postprandial hypotension can cause dizziness, light-headedness, faintness, 
and falls. If an older person experiences these symptoms after eating, 
doctors measure blood pressure before and after meals to determine if 
postprandial hypotension is the cause.

People who have symptoms of postprandial hypotension should not take 
antihypertensive drugs before meals and should lie down after meals. Taking 
a smaller dose of the antihypertensive drugs and eating small, 
low-carbohydrate meals more frequently may help reduce the effects of this 
disorder. For some people, walking after a meal helps improve blood flow, 
but blood pressure may fall when they stop walking.

Taking certain drugs before a meal may help. For example, nonsteroidal 
anti-inflammatory drugs (NSAIDs) cause salt to be retained and thus increase 
blood volume. Caffeine causes blood vessels to constrict. Caffeine should be 
taken only before breakfast so that sleep is not affected and the person 
does not become tolerant of caffeine's effects. For people who have severe 
symptoms that do not respond to other measures and who are in the hospital, 
injections of the drug octreotide also known as SANDOSTATIN
may help by reducing the amount of blood flowing to the intestine.