Key result
In healthy older adults, 100 mg of acarbose significantly attenuated the postprandial fall in mean arterial pressure (AUC 10,625 vs 10,366 mmHg.min, P=0.005) after oral sucrose, whereas gastric distension had no effect.
Why the study?
Postprandial hypotension occurs frequently in older adults and type 2 diabetes but lacks satisfactory treatment, and it was unknown whether gastric distension and acarbose have additive effects to attenuate sucrose-induced blood pressure fall.
Does acarbose and/or gastric distension prevent the postprandial fall in blood pressure in healthy older adults?
RCT (n=10)
Randomized, crossover design
No
Does acarbose and/or gastric distension prevent the postprandial fall in blood pressure in healthy older adults?
Absolute Event Rate: 10625% vs 10366%
p-value: p=0.005
Acarbose, but not gastric distension, effectively attenuates the postprandial fall in blood pressure and rise in superior mesenteric artery blood flow in healthy older adults.
Acarbose attenuates postprandial BP falls in older adults; extends evidence for splanchnic-flow modulation beyond glycemic control.
BACKGROUND: Postprandial hypotension (PPH) occurs frequently in the elderly and patients with type 2 diabetes, and lacks a satisfactory treatment. Gastric distension and the α-glucosidase inhibitor, acarbose, may attenuate the postprandial fall in blood pressure (BP) by complementary mechanisms. We aimed to determine whether gastric distension and acarbose have additive effects to attenuate the fall in BP induced by oral sucrose. METHODS: Ten healthy older adults (74.0 ± 1.4 yr) had measurements of BP and superior mesenteric artery (SMA) blood flow for 120 min after receiving either (i) the 'study drink' of 100 g sucrose in 300 mL of water (control treatment), (ii) a 300 mL water 'preload' 15 min before the 'study drink' (distension treatment), (iii) 100 mg acarbose dissolved in the 'study drink' (acarbose treatment) or (iv) a 300 ml water 'preload' 15 min before 100 mg acarbose dissolved in the 'study drink' (acarbose and distension treatment). RESULTS: response to acarbose (P = 0.44) and there was no effect of gastric distension alone (P = 0.68). Both acarbose treatments attenuated the rise in SMA blood flow (P = 0.003), whereas gastric distension had no effect. CONCLUSIONS: In healthy older adults, acarbose (100 mg), but not gastric distension, attenuates the fall in BP and rise in SMA blood flow after oral sucrose. The observations support the use of acarbose, but not gastric distension, to attenuate a postprandial fall in BP. TRIAL REGISTRATION: The study was retrospectively registered at ( ACTRN12618000152224 ) on February 02nd 2018.
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Pham et al. (2019) conducted an RCT in Healthy older adults (evaluating postprandial blood pressure) (n=10). Acarbose vs. Control (100 g sucrose in 300 mL water) was evaluated on Area under the curve (AUC) 0-120min for mean arterial pressure (MAP) (p=0.005). In healthy older adults, 100 mg of acarbose significantly attenuated the postprandial fall in mean arterial pressure (AUC 10,625 vs 10,366 mmHg.min, P=0.005) after oral sucrose, whereas gastric distension had no effect.
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