Objective: Decline in systolic or diastolic blood pressure is relatively common in the elderly and associated with increased all cause mortality. Posprandial Hypotension (PPH) increases in prevalence with age and is a potential cause of falls and syncope. Previous investigators have measured postprandial declines in blood pressure in independent eating patients but not in tubo-enterally feeding (either nasogastric or gastrostomy tube) used in long term wards for feeding and hydration in patients with end-stage dementia. Those patients cannot complain of their unpleasant symptoms because of communication handicap.
Design: Prospective comparative study
Materials and Methods: 76 elderly tubo-enterally fed demented patients participated in this study. Blood pressure was monitored before and every 15 minutes after a standard meal for up to 1.5 hours thereafter. 27 independent eating patients were in the control group.
Results: The magnitude of the falls in systolic, diastolic and mean blood pressure were nearly the same in both TEF groups - NGFT and PEG: mean blood pressure decreased 75 and 90 minutes after meal, and in the control group, the same mean BP decreased only 30 to 45 minutes after the meal.
Conclusion: Blood pressure declined in the two groups of demented tubo-enterally fed patients (NGFT and PEG) but markedly later than in the control independent eating group. The decline - although not reaching 20 mg Hg, the required criteria for PPH - may account for postprandial clinical events in this communication handicapped group of patients.
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