Postprandial Hypotension

To the Editor: Drs. Aronow and Ahn' are to be applauded for their research pursuit in the September 1994 issue of JAGS reporting baseline data from a cohort of institutionalized older subjects who were evaluated for postprandial changes in blood pressure. The phenomenon of postprandial hypotension has been reported extensively in the literature. However, no study to date has evaluated the prognostic significance of this phenomenon in predicting future coronary events. Given the extensive research, which has shown that abnormalities in the autonomic nervous system's regulation of hemodynamic parameters are important predictors of mortality post myocardial infarction and in patients with congestive heart failure, the utility of a simple noninvasive screen such as postprandial hypotension has appealing therapeutic implication. However, Potter et al.2 showed that after high carbohydrate and high protein meals there was a reduction in supine and erect blood pressures, whereas after a high fat meal there was no change. Was meal composition similar among all residents or was this controlled for in the present study?