Background: Type 2 diabetes (T2DM) is a common etiology of postprandial hypotension (PPH), possibly as a result of autonomic neuropathy resulting in baroreflex dysfunction. We examined baroreflex function in older adults with PPH (with and without T2DM) during a standardized meal test.

Methods: 57 adults with PPH (age >= 65; 30 without T2DM, 27 with T2DM) were recruited sequentially from a geriatric medicine clinic (mean age 77.9±0.9 years, 54% female) and had meal tests performed. A Finometer (Finapres Medical Systems) was used to monitor blood pressure. The baroreflex effectiveness index (BEI, percent) was calculated using the sequence method.

Results: Baseline BEI showed no association with the average PPH response (p=0.521), the maximal PPH response (p=0.282), or the number of hypotensive episodes (p=0.859). As shown in Figure 1, baseline BEI was lower in subjects with T2DM than in those without T2DM (p<0.001), but this impairment in baroreflex function was not observed postprandially. There was no significant difference in the average PPH response between those with and without T2DM (p=0.358).

Conclusions: Although older subjects with PPH secondary to T2DM have lower baseline baroreflex function than older subjects with PPH without T2DM, this baroreflex impairment was not associated with the size of the PPH response. This suggests that PPH in the T2DM is not due to impairments in the arterial baroreflex.

K.M. Madden: None. B. Feldman: None. G.S. Meneilly: Advisory Panel; Self; Merck Sharp & Dohme Corp., Novo Nordisk Inc.


Allan M. McGavin Foundation; Canadian Diabetes Association

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