Osteopathic manipulative treatment over four weeks reduced the mean Orthostatic Hypotension Symptom Assessment score from 2.67 to 1.33 in an 84-year-old man with postprandial cardiovascular symptoms.
Case Report (n=1)
No
Does osteopathic manipulative treatment improve symptoms and autonomic regulation in a patient with postprandial hypotension?
Osteopathic manipulative treatment may improve symptoms and autonomic regulation in patients with postprandial hypotension, though larger controlled studies are needed.
Absolute Event Rate: 1.33% vs 2.67%
Postprandial cardiovascular symptoms may be associated with alterations in autonomic regulation, particularly when the postprandial decrease in blood pressure is not accompanied by an adequate compensatory increase in heart rate. We report the case of an 84-year-old man with a long-standing history of postprandial symptoms, characterised by dizziness, generalised weakness, fatigue, and presyncope occurring between 10 and 30 minutes after food intake, with improvement in the supine position. The patient presented with postprandial hypotension without an appropriate increase in heart rate. A structured osteopathic manipulative treatment (OMT) protocol was applied over four weeks, targeting regions associated with vagal pathways. Symptom severity was assessed using the Orthostatic Hypotension Symptom Assessment (OHSA) subscale, and haemodynamic parameters were recorded both in the clinical setting and at home, alongside evaluation of autonomic function through heart rate variability (HRV). Following the intervention, the mean OHSA score decreased from 2.67 to 1.33 and remained stable at follow-up. Home monitoring showed a reduction in the magnitude of the postprandial blood pressure drop during intermediate periods, accompanied by a consistent increase in heart rate after food intake. In the clinical setting, consistent reductions in both blood pressure and heart rate were observed. HRV analysis revealed a decrease in low-frequency (LF) power and in LF in normalised units (LFnu), alongside a progressive increase in high-frequency (HF) power and in HF in normalised units (HFnu), with a reduction in the LF/HF ratio. Overall, these findings suggest a possible association between OMT and clinical improvement, accompanied by haemodynamic and autonomic changes consistent with autonomic modulation, potentially at the vagal level. However, these results should be interpreted with caution due to the single-case nature of the study, and further research with larger sample sizes and controlled designs is required to confirm these findings.
Harbi Shehadeh (Thu,) conducted a case report in Postprandial cardiovascular symptoms (n=1). Osteopathic manipulative treatment (OMT) vs. Baseline was evaluated on Mean Orthostatic Hypotension Symptom Assessment (OHSA) score. Osteopathic manipulative treatment over four weeks reduced the mean Orthostatic Hypotension Symptom Assessment score from 2.67 to 1.33 in an 84-year-old man with postprandial cardiovascular symptoms.