Effect of coffee and tea drinking on postprandial hypotension in older men and women.

Abstract

1. A postprandial fall in blood pressure (BP) in older men and women increases the risks of falls and impaired cerebral perfusion. Postprandial hypotension has been suggested to be greater in hypertensive subjects, particularly in those on antihypertensive medication. 2. Caffeine, given as tablets or as strong coffee, may attenuate postprandial falls in BP in older subjects, but findings are not consistent. 3. In a randomized controlled intervention in 171 healthy non-smokers over the age of 50 years, we compared the effects of coffee-drinking with abstaining from caffeine in normotensives (NT), untreated hypertensives (UNHT) and subjects on drug treatment for hypertension (TRHT). Tea drinking was a third intervention used only in TRHT. 4. After adjustment for the effects of the initial value on changes in BP, there were no significant differences related to hypertension or to hypertensive agents in the magnitude of postprandial falls in BP. 5. After the intervention, changes in fasting supine and standing systolic BP and heart rate (HR) were not significantly different from controls in NT, UNHT and TRHT, but fasting supine and standing diastolic BP were significantly higher in coffee drinkers in the UNHT group. 6. In normotensive coffee drinkers there was a significant reduction in the postprandial fall in supine systolic BP of 4.1 mmHg (+/- s.e.m. 1.1) and in standing systolic BP of 5.2 +/- 1.6 mmHg. Among untreated hypertensives, abstainers showed a significant attenuation of the postprandial fall in supine, but not standing, systolic BP. Among treated hypertensives who were tea drinkers the postprandial fall decreased for supine systolic BP by 3.8 +/- 1.2 mmHg (P = 0.029) and for standing systolic BP by 5.2 +/- 2.1 mmHg. 7. Both tea and coffee were potentially beneficial in decreasing postprandial falls in systolic BP, but coffee drinking may increase fasting diastolic pressures in untreated hypertensives.