Symptoms of postprandial hypotension are easily confused with a stroke
N.M.K (living in District 3, Ho Chi Minh City) is 67 years old, suffering from high blood pressure for a long time. Recently, I often feel dizzy. Dr. K. went to a specialist hospital and was diagnosed with orthostatic hypotension.
6/7/2021 11:18:01 PM
Not sure yet, Dr. K. went to another hospital and was confirmed to have postural hypotension and explain that he suddenly changed his position in the morning when he woke up, so his blood pressure dropped.
Mr. K. still felt uneasy because the dizziness occurred after he walked around the house a few times. Finally, fearing a "stroke," Dr. K. decided to go to another medical facility.
Dr. Phung Ngoc Minh Tan, Cardiology Department of CarePlus International Clinic System, met Dr. K. after visiting CarePlus's clinic. After examining, studying the medical history and living habits, and diet of Dr. K., Dr. Tan found out the cause of Dr. K.'s dizziness.
According to Dr. Tan, another "brother" disease, postprandial hypotension (PPH), needs attention. According to a Dutch registry study on elderly patients, postprandial hypotension is more common than orthostatic hypotension. In addition, postprandial hypotension diagnoses when blood pressure decreased more than 20 mmHg within 2 hours compared to preprandial blood pressure.
This condition can be confused with hypoglycemia. Distinguish from orthostatic hypotension:
1. Postural hypotension usually occurs in the early morning when the patient wakes up. So the patient "gets up" right away. In contrast, postprandial hypotension usually occurs after eating breakfast, peaking 30-60 minutes after eating. Which can last up to 120 minutes after eating.
2. Postprandial hypotension occurs quickly, disappears quickly, and postprandial hypotension occurs slowly and lasts longer. However, about 10-20% of cases have both symptoms at the same time.
Explaining this symptom in Dr. K., Dr. Tan said: "Normally after eating, the blood vessels in the intestines are dilated, giving priority to more blood supply, so the blood vessels in other organs will shrink to compensate, helping other organs still ensure operation. The receptors in the stomach help to recognize the body is eating to coordinate this action. This phenomenon is disturbed in patients with hypertension, heart failure, diabetes, chronic kidney failure, Parkinson's,... The full mechanism is still being studied."
Postprandial hypotension is associated with falls, stroke, transient ischemic attack, and angina. To solve this situation, Dr. Tan came up with a solution:
- If Dr. K. drinking a cup of coffee after eating can help because coffee helps stimulate Adenosine receptors.
- Dr. K. should limit foods containing a lot of starch and sugar because these substances are absorbed very quickly in the stomach. The receptor does not warn in time for the blood vessels to expand reasonably; Instead, eat foods rich in fiber.
- Some previous studies suggested sitting or lying down after eating for 30-60 minutes, new studies show that walking, gentle movement helps to improve better.
Uncle K. has a habit of eating half a loaf of bread and then going to exercise; now, he has switched to oatmeal, ate half an apple, drank coffee, and then went for a light walk with his aunt. After the first follow-up visit with Dr. Tan last week, Dr. K. had markedly improved symptoms, stable blood pressure, more relaxed and gentle spirit.
(Recorded according to the narration of Dr. Phung Ngoc Minh Tan, Cardiology Department of CarePlus International Clinic System)