The investigation of therapeutic effect and its mechanism of acarbose on postprandial hypotension with concomitant abnormal glucose metabolism in elderly patients

Abstract

Objective To explore the of therapeutic effect and its mechanism of acarbose on postprandial hypotension(PPH)with concomitant abnormal glucose metabolism in elderly patients. Methods The 43 elderly patients(>80 years)with PPH and concomitant abnormal glucose metabolism were randomly divided into two groups: acarbose group(n=21)and control group(n=22). Before and two weeks after treatment, the blood pressure, blood glucose level, and the superior mesenteric artery blood flow of the two groups were monitored. Results The decrement of postprandial systolic blood pressures was lower in acarbose group than in control group〔(22.3±6.9)vs.(30.7±8.4)mmHg, 1 mmHg=0.133 kPa, P=0.000〕. The increment of postprandial blood glucose was lower in acarbose group than in control group〔(2.3±1.6)vs.(3.5±0.9)mmol/L, P=0.002〕. The decrement of postprandial diastolic blood pressure had no significant difference between two groups〔(11.3±5.3)vs.(10.8±5.6)mmHg, P=0.058〕. The incidence rate of PPH before versus after treatment was 100%(21/21 cases)vs.47.6%(10/21 cases)(P=0.002)in acarbose treatment group and 100%(21/21 cases)vs.100%(21/21 cases)in control group(P>0.05). Acarbose treatment showed no significant side effects. Conclusions The abnormal increase in postprandial splanchnic perfusion is one of the reasons for PPH.Acarbose may exert its role in PPH treatment by reducing superior mesenteric artery blood flow.Giving acarbose to treat PPH with concomitant abnormal glucose metabolism is effective and safe in very old patients. Key words: Hypotension; Postprandial period; Mesenteric arteries