| Objective: The purposes of this study were to study the prevalence and clinicalcharacteristics of postprandial hypotension (PPH) in hospitalized patients with essentialhypertensive (EH); explored the relationship between PPH and organ target damage.Methods: One hundred and eighteen hospitalized patients with EH were recruited in thisstudy, most of which were received by antihypertensive drug treatment according todifferent condition,56cases male and62case female, with an average age of62.77±9.20years, average duration of10±9.20years. The BP and heart rate (HR) of selected patientswere measured5minutes before meals and every15minutes interval with2hours aftermeals. The patients were divided into two groups according to decreased values of SBPafter meals: postprandial hypotension group (PPH, n=83) and non-postprandialhypotension (NPPH, n=35). In the meantime, Intima-media thickness (IMT) and plaqueformation of carotid artery were respectively measured by high-resolution colorDoppler scans ultrasonics, and recorded the average of three times measurement, thenthe plaque occurrence, Crouse score of plaque and grade score of carotid arteryatherosclerosis were calculated. Left atrial end systolic diameter (LAs), E peak velocities(E) and A peak velocities (A) of mitral valve flow, interventricular septal thickness (IVST),left ventricular end-diastolic diameter (LVDd), and left ventricular posterior wall thickness(LVPWT) were measured by echocardiogram in all the patients. Left ventricular vjectionfraction (LVEF), Left ventricular fraction shortening (LVFS), E/A ratio (E/A), leftventricular mass index (LVMI) was calculated. Blood serum creatinine, urea nitrogen andCys-C levels were measured, then estimated glomerular filtration rate (eGFR) wascalculated.Results:（1）The descriptive analysis of the meal-induced changes in BP in subjects with essential hypertension (EH) showed that most of them reduced in both SBP and DBPwithin2houres after three meals a day, respectively and the prevalence of PPH in allpatients was70.34%. The PPH prevalence at breskfast (50.08%) was greater than that atlunch(35.59%) and at supper(27.79%)(P<0.01). Moreover, the decreased SBP and DBPafter breakfast were more than those after lunch and after dinner in PPH group (P<0.05).（2）The increased incidence of PPH was related with the age and the level ofsystolic blood pressure before meal and the drop amplitude of postprandial blood pressure(P<0.05).（3）The detection ratio of plaque, Crouse scose of plaque and grade scoreof carotid artery atherosclerosis in PPH group were significantly increased than inNPPH group (P<0.05); There was significant difference in both hard plaque andsoft plaque between PPH and NPPH group (P<0.05).（4）Correlation analysis results showed that the age were correlation with thedecreased maximum values of SBP after breakfast(r=0.190，P<0.05)and the decreasedmaximum values SBP after lunch (r=0.218), the levels of SBP before meal was correlationwith the drop values after meal [breakfast(r=0.397，P<0.05), lunch (r=0.451，P<0.05) andsupper(r=0.477，P<0.05)], and the carotid plaques Crouse were correlation with thedecreased amplitude of SBP after breakfast(rs=0.208，P<0.05). Logistic regression analysisresults showed that the age, the BP before meal, the degree of carotid artery atherosclerosiswere independent predictors of PHH in patients with essential hypertension, respectively.Conclusion:（1）The incidence of PPH in hospitalized EH patients is common, andthe incidence of PPH and drop amplitude of blood pressure were the highest after breakfast.（2）The age, basic SBP before meals, and degree of carotid artery atherosclerosis may bethe independent risk factors of PPH in hospitalized patients with EH. |
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