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Pharmacological Treatment of Postprandial Reductions in Blood Pressure: A Systematic Review
Author(s) -
Ong Alice C. L.,
Myint Phyo K.,
Potter John F.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12728
Subject(s) - medicine , postprandial , randomized controlled trial , systematic review , medline , meta analysis , cinahl , clinical trial , acarbose , intensive care medicine , psychological intervention , endocrinology , diabetes mellitus , insulin , psychiatry , political science , law
Objectives To systematically review the current literature on the pharmacological treatment of postmeal reductions in blood pressure ( BP ). Design A systematic literature search and standardized data collection of randomized controlled trials on the pharmacological prevention of postprandial reductions in BP in adults using MEDLINE (1950–), EMBASE (1980–), and CINAHL databases was conducted up to July 2013. Bibliographies of relevant reports were also hand‐searched to identify all potentially eligible studies. Setting Systematic review of randomized controlled trials using PRISMA guidelines. Measurements Articles were assessed using the Critical Appraisal Skills Programme for randomized controlled trials. Results Thirteen articles reporting 12 studies (1 study was reported in 2 articles) demonstrated that caffeine (5 studies); acarbose; 3,4‐ DL ‐threo‐dihydroxyphenylserine; guar gum (3 studies); and octreotide (2 studies) statistically attenuated the postprandial reduction in BP . One caffeine study did not show this. Most studies did not include individuals with symptomatic postprandial hypotension ( PPH ), so interpretation and application of these findings to this patient group should be made with caution. For symptomatic participants, there was improvement with acarbose but none with caffeine. Differences in the way the data were presented in the studies did not allow for quantification of treatment effects using meta‐analysis. Conclusion Drug interventions can attenuate postprandial reductions in BP , but they may not necessarily be effective in people with symptomatic PPH .