Gastric distension attenuates the hypotensive effect of intraduodenal glucose in healthy older subjects

2008 ◽  
Vol 295 (2) ◽  
pp. R472-R477 ◽  
Author(s):  
Diana Gentilcore ◽  
James H. Meyer ◽  
Christopher K. Rayner ◽  
Michael Horowitz ◽  
Karen L. Jones
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Gastric Emptying ◽  
Healthy Subjects ◽  
Hypotensive Effect ◽  
Gastric Distension ◽  
Two Dimensional ◽  
Current Management ◽  
Older Subjects ◽  
Hypotensive Response

Postprandial hypotension occurs frequently, and current management is suboptimal. Recent studies suggest that the magnitude of the fall in postprandial blood pressure (BP) may be attenuated by gastric distension. The aim of this study was to determine the effect of gastric distension on the hypotensive response to intraduodenal (ID) glucose. Eight healthy subjects (5 males, 3 females, aged 65–76 years) received an ID infusion of either 1) 50 g glucose in 300 ml saline (ID glucose) over 60 min ( t = 0–60 min), 2) 50 g glucose in 300 ml saline over 60 min and intragastric ( 4 ) infusion of 500 ml water between t = 7–10 min (IG water and ID glucose), or 3) ID saline (0.9%) infusion over 60 min and IG infusion of 500 ml water (IG water and ID saline) all followed by ID saline infusion for another 60 min ( t = 60–120 min) on three separate days. BP and heart rate (HR) were measured. Gastric emptying (GE) of the IG water was quantified by two-dimensional ultrasonography. Between t = 0–60 min, systolic and diastolic BP was greater ( P < 0.05 for both) with IG water and ID saline compared with IG water and ID glucose, and less ( P < 0.05 for both) with ID glucose compared with IG water and ID glucose. These effects were evident at relatively low IG volumes (∼300 ml). GE was faster with IG water and ID saline when compared with IG water and ID glucose. We conclude that, in healthy older subjects, IG administration of water markedly attenuates the hypotensive response to ID glucose, presumably as a result of gastric distension.

Effects of drink volume and glucose load on gastric emptying and postprandial blood pressure in healthy older subjects

2005 ◽  
Vol 289 (2) ◽  
pp. G240-G248 ◽  
Author(s):  
Karen L. Jones ◽  
Deirdre O’Donovan ◽  
Antonietta Russo ◽  
James H. Meyer ◽  
Julie E. Stevens ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Gastric Emptying ◽  
Glucose Concentration ◽  
The Elderly ◽  
Gastric Distension ◽  
Oral Glucose ◽  
Glucose Content ◽  
Older Subjects ◽  
Hypotensive Response

Postprandial hypotension (PPH) occurs frequently in the elderly; the magnitude of the fall in blood pressure (BP) is related to the rate of glucose entry into the duodenum during intraduodenal glucose infusion and spontaneous gastric emptying (GE). It is unclear if glucose concentration affects the hypotensive response. Gastric distension may attenuate PPH; therefore, meal volume could influence the BP response. We aimed to determine the effects of 1) drink volume, 2) glucose concentration, and 3) glucose content on the BP and heart rate (HR) responses to oral glucose. Ten subjects (73.9 ± 1.2 yr) had measurements of BP, GE, and blood glucose on 4 days after 1) 25 g glucose in 200 ml (12.5%), 2) 75 g glucose in 200 ml (37.5%), 3) 25 g glucose in 600 ml (4%), and 4) 75 g glucose in 600 ml (12.5%). GE, BP, HR, and blood glucose were measured for 180 min. After all drinks, duodenal glucose loads were similar in the first 60 min. Regardless of concentration, 600-ml (but not 200-ml) drinks initially increased BP, and in the first 30 min, systolic BP correlated ( P < 0.01) with volume in both the proximal and total stomach. At the same concentration (12.5%), systolic BP fell more ( P = 0.02) at the smaller volume; at the same volumes, there were no effects of concentration on BP. There was no difference in the glycemic response to drinks of identical glucose content. We conclude that 1) ingestion of glucose at a higher volume attenuates and 2) under constant duodenal load, glucose concentration (4–37%) does not affect the fall in BP.

Effect of solid meal on gastric emptying of, and glycemic and cardiovascular responses to, liquid glucose in older subjects

2003 ◽  
Vol 284 (4) ◽  
pp. G655-G662 ◽  
Author(s):  
Melanie K. Berry ◽  
Antonietta Russo ◽  
Judith M. Wishart ◽  
Anne Tonkin ◽  
Michael Horowitz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Glucose ◽  
Gastric Emptying ◽  
Serum Insulin ◽  
Cardiovascular Responses ◽  
Oral Glucose ◽  
Mixed Meal ◽  
Solid Meal ◽  
Older Subjects

Gastric emptying is a determinant of the postprandial glycemic and cardiovascular responses to oral carbohydrate. We evaluated the effects of a solid meal on gastric emptying and the glycemic and cardiovascular responses to oral glucose in healthy older subjects. Ten subjects aged 72.1 ± 1.9 yr were studied. Each subject had measurements of gastric emptying, blood glucose, serum insulin, blood pressure, and heart rate after ingestion of a 50-g glucose drink (300 ml) with (mixed meal) or without (liquid only) a solid meal (300 g ground beef). Gastric emptying of liquid was initially slightly more rapid ( P < 0.05) after the mixed meal compared with liquid only at 5 min (92.0 ± 1.5 vs. 96.0 ± 1.3%) and much slower ( P < 0.05) after 120 min. The time to peak blood glucose was less (39.0 ± 4.0 vs. 67.5 ± 10.3 min; P < 0.01) and blood glucose subsequently lower ( P < 0.01) after the mixed meal. The increase in serum insulin was greater ( P < 0.001) after the mixed meal. Blood pressure fell ( P < 0.05) in the first 30 min, with no difference between the two meals. Increase in heart rate after both meals ( P < 0.005), was greater ( P< 0.05) after the mixed meal. The presence of a noncarbohydrate solid meal had discrepant effects on early and subsequent emptying of a nutrient liquid, which affects postprandial glycemia and increased heart rate.

scholarly journals Orlistat accentuates the fat-induced fall in blood pressure in older adults

2011 ◽  
Vol 106 (3) ◽  
pp. 417-424 ◽  
Author(s):  
Kamilia Tai ◽  
Diana Gentilcore ◽  
Karen L. Jones ◽  
Lisa Banh ◽  
Odd Helge Gilja ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Gastric Emptying ◽  
Water Control ◽  
Fat Digestion ◽  
Blood Pressures ◽  
Fat Infusion ◽  
Older Subjects ◽  
Artery Flow ◽  
Hypotensive Response

Postprandial hypotension may be influenced by the digestion of fat. The aim of the present study was to evaluate the hypothesis that products of fat digestion mediate the hypotensive response to fat. In part A of the study, nine healthy older subjects were studied on three separate occasions in randomised order. Blood pressure, heart rate (HR), plasma TAG and gastric emptying were measured following the ingestion of equivolaemic drinks: (1) 300 ml of high-fat drink (88 % fat); (2) fat drink mixed with 120 mg orlistat (lipase inhibitor); (3) water (control). In part B of the study, ten healthy older subjects were studied on two separate occasions. Blood pressure, HR, plasma TAG and superior mesenteric artery flow were measured during 90 min intraduodenal infusions of 10 % intralipid (2·7 ml/min), with and without 120 mg orlistat. Oral fat ingestion was associated with decreases in systolic and diastolic blood pressures (both P = 0·0001) that were greater when orlistat was co-administered (both P < 0·05), and an increase in HR (P = 0·0001) that was inhibited by orlistat co-administration (P < 0·03). Gastric emptying was slowed by oral fat digestion, and orlistat administration inhibited this slowing (P < 0·04). Intraduodenal fat infusion was not associated with changes in blood pressure but increased HR (P < 0·0001), an effect attenuated by orlistat (P < 0·05). In conclusion, orlistat potentiates the hypotensive response to oral fat in older adults, possibly as a result of faster gastric emptying of fat. The results do not support a role for fat digestion in lowering blood pressure.

Comparative effects of oral and intraduodenal glucose on blood pressure, heart rate, and splanchnic blood flow in healthy older subjects

2009 ◽  
Vol 297 (3) ◽  
pp. R716-R722 ◽  
Author(s):  
Diana Gentilcore ◽  
Nivasinee S. Nair ◽  
Lora Vanis ◽  
Christopher K. Rayner ◽  
James H. Meyer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Blood Glucose ◽  
Three Dimensional ◽  
The Elderly ◽  
Splanchnic Blood Flow ◽  
Gastric Distension ◽  
Oral Glucose ◽  
Older Subjects

Postprandial hypotension occurs frequently, particularly in the elderly. The magnitude of the fall in blood pressure (BP) and rise in heart rate (HR) in response to enteral glucose are greater when gastric emptying (GE) or small intestinal infusion are more rapid. Meal ingestion is associated with an increase in splanchnic blood flow. In contrast, gastric distension may attenuate the postprandial fall in BP. The aims of this study were to evaluate, in older subjects, the comparative effects of intraduodenal glucose infusion, at a rate similar to GE of oral glucose, on BP, HR, superior mesenteric artery (SMA) flow, and blood glucose. Eight healthy subjects (5 men, 3 women, age 66–75 yr) were studied on two occasions. On day 1, each subject ingested 300 ml of water containing 75 g glucose. GE was quantified by three-dimensional ultrasonography between time t = 0–120 min, and the rate of emptying (kcal/min) was calculated. On day 2, glucose was infused intraduodenally at the same rate as that on day 1. On both days, BP, HR, SMA flow, and blood glucose were measured. The mean GE of oral glucose was 1.3 ± 0.1 kcal/min. Systolic BP ( P < 0.01), SMA flow ( P < 0.05), and blood glucose ( P < 0.01) were greater and HR less ( P < 0.01) after oral, compared with intraduodenal, glucose. There were comparable falls in diastolic BP during the study days ( P < 0.01 for both). We conclude that the magnitude of the fall in systolic BP and rise in HR are less after oral, compared with intraduodenal, glucose, presumably reflecting the “protective” effect of gastric distension.

scholarly journals Cortisol Levels and Autonomic Control of Heart Rate in Healthy Subjects

2017 ◽  
Vol 17 (2) ◽  
pp. 5-14 ◽  
Author(s):  
Milana Drumond Ramos Santana ◽  
Eli Carlos Martiniano ◽  
Larissa Raylane Lucas Monteiro ◽  
Maria Do Socorro Santos De Oliveira ◽  
Vitor E. Valenti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Salivary Cortisol ◽  
Healthy Subjects ◽  
Autonomic Control ◽  
Autonomic Modulation ◽  
Cardiac Autonomic Modulation ◽  
Cortisol Levels ◽  
Modulation Methods

AbstractIntroduction: There is an increase in level of stress in the general population because of the social, personal and professional demands. Currently, there are only simple tools that can safely measure this stress such as levels of cortisol and heart rate variability (HRV). Objective: To analyze the relationship between salivary cortisol and the cardiac autonomic modulation. Methods: A total of fifty-one male and female subjects between 18 and 40 years old were evaluated. Saliva collection was achieved for the salivary cortisol dosage. The collection was performed through the SalivetteR tube. After this collection, the median cortisol levels (0.24 ug/dl) were analyzed and the volunteers were divided into two groups: i) cortisol below the mediane ii) cortisol above the median. After this division, each group consisted of 25 volunteers and then was verified the following information: age, gender, weight, height, body mass index (BMI), blood pressure. Shortly thereafter was assessment of cardiac autonomic modulation por meio da HRV. The Polar RS800cx heart rate receiver was placed on the chest of the volunteers, in the vicinity of the distal third of the sternum. The volunteers were instructed to remain in rest with spontaneous breathing in dorsal position for 20 minutes. HRV analysis included geometric, time and frequency domain indices. Results: There were no statistical differences for the two groups regarding systolic and diastolic blood pressure, heart rate, RR intervals or linear and frequency indices for the volunteers. In addition, also there was no correlation the cortisol with the analyzed variables (SAP, p=0.460; DAP, p = 0.270; HR, p = 0.360; RR, p = 0.380; SDNN, p = 0.510; rMSSD, p = 0.660; pNN50, p = 0.820; RRtri, p = 0.170; TINN, p = 0.470; SD1, p = 0.650; SD2, p = 0.500; LF [ms2], p = 0.880; LF [nu], p = 0.970; HF [ms2], p = 0.870; HF [nu], p = 0.960; LF/HF, p = 0.380 Conclusion: Heart rate variability autonomic control was unchanged in healthy subjects with physiological distribution of salivary cortisol levels. There was no association between normal salivary cortisol and resting autonomic regulation of heart rate.

scholarly journals Diurnal Corrected QT Interval and QT Dispersion Variation in Non-Alcoholic Cirrhotic Patients and Healthy Control: A Case-Control Study, Iran

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Taghi Amiriani ◽  
Vahid Khori ◽  
Ali Davarian ◽  
Niloofar Rajabli ◽  
Mahsa Niknam ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Diurnal Variation ◽  
Healthy Subjects ◽  
Alcoholic Cirrhosis ◽  
Qt Dispersion ◽  
Qtc Interval ◽  
Healthy Controls ◽  
Cirrhotic Patients ◽  
The Mean

Background: Cirrhosis could lead to a long corrected QT (QTc) interval in a subgroup of patients, but there are spare data on its diurnal variation. Objectives: The present study aimed to determine the diurnal variation of QTc interval and its relationship to heart rate and blood pressure variation during 24-hour Holter-monitoring in non-alcoholic cirrhosis in comparison with the healthy controls. Methods: The study population comprised 15 patients with non-alcoholic cirrhosis and 15 healthy subjects, undergoing 24-hour electrocardiogram (ECG), heart rate, and blood pressure monitoring. The mean QT interval, mean QTc, maximum and minimum QT, QT dispersion (QT disp), heart rate, and mean arterial blood pressure were measured for each person for 24 hours. Liver stiffness measurement (LSM) was performed by FibroScan® 502 machine (EchoSense, Paris, France, 5 MHz). The results were demonstrated as percentages and mean ± SD. P value ≤ 0.05 was considered significant. Results: Mean QTc was significantly higher in cirrhosis (438 ms) than healthy controls (401.7 ms) (P = 0.03). The mean heart rate was significantly different in cirrhotic patients (79.6 ± 2.9/bpm) compared to healthy controls (72.47 ± 2.0/bpm) (P = 0.05). Conclusions: In this study, QTc was prolonged and increased with the severity of cirrhosis, and its diurnal variation in cirrhosis was different from healthy subjects.

Age dependency of cardiovascular autonomic responses to head-up tilt in healthy subjects

2004 ◽  
Vol 96 (6) ◽  
pp. 2333-2340 ◽  
Author(s):  
Tomi Laitinen ◽  
Leo Niskanen ◽  
Ghislaine Geelen ◽  
Esko Länsimies ◽  
Juha Hartikainen
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
High Frequency ◽  
Healthy Subjects ◽  
Baroreflex Sensitivity ◽  
Low Frequency ◽  
Upright Position ◽  
Vascular Responses ◽  
Autonomic Responses ◽  
Head Up Tilt

In elderly subjects, heart rate responses to postural change are attenuated, whereas their vascular responses are augmented. Altered strategy in maintaining blood pressure homeostasis during upright position may result from various cardiovascular changes, including age-related cardiovascular autonomic dysfunction. This exploratory study was conducted to evaluate impact of age on cardiovascular autonomic responses to head-up tilt (HUT) in healthy subjects covering a wide age range. The study population consisted of 63 healthy, normal-weight, nonsmoking subjects aged 23–77 yr. Five-minute electrocardiogram and finger blood pressure recordings were performed in the supine position and in the upright position 5 min after 70° HUT. Stroke volume was assessed from noninvasive blood pressure signals by the arterial pulse contour method. Heart rate variability (HRV) and systolic blood pressure variability (SBPV) were analyzed by using spectral analysis, and baroreflex sensitivity (BRS) was assessed by using sequence and cross-spectral methods. Cardiovascular autonomic activation during HUT consisted of decreases in HRV and BRS and an increase in SBPV. These changes became attenuated with aging. Age correlated significantly with amplitude of HUT-stimulated response of the high-frequency component ( r = -0.61, P < 0.001) and the ratio of low-frequency to high-frequency power of HRV ( r = -0.31, P < 0.05) and indexes of BRS (local BRS: r = -0.62, P < 0.001; cross-spectral baroreflex sensitivity in the low-frequency range: r = -0.38, P < 0.01). Blood pressure in the upright position was maintained well irrespective of age. However, the HUT-induced increase in heart rate was more pronounced in the younger subjects, whereas the increase in peripheral resistance was predominantly observed in the older subjects. Thus it is likely that whereas the dynamic capacity of cardiac autonomic regulation decreases, vascular responses related to vasoactive mechanisms and vascular sympathetic regulation become augmented with increasing age.

Effect of Essential Oil on Heart Rate and Blood Pressure Among Healthy Subjects in Classroom

Epidemiology ◽  
2011 ◽  
Vol 22 ◽  
pp. S39-S40
Author(s):  
Jia-Jang Yang ◽  
Lian-Yu Lin ◽  
Chih-Ming Ma ◽  
Kai-Jen Chuang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Essential Oil ◽  
Healthy Subjects

The Transient Anti-Hypertensive Effect of Phentolamine in Patients Receiving Beta-Blocker Treatment

1973 ◽  
Vol 1 (2) ◽  
pp. 462-464
Author(s):  
Ann Dawson ◽  
Ian Smith ◽  
Brian F Johnson
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Essential Hypertension ◽  
Beta Blocker ◽  
Peak Plasma ◽  
Beta Blockers ◽  
Peak Plasma Concentration ◽  
Hypotensive Effect ◽  
Additional Reduction ◽  
Standing Blood Pressure

In seven hypertensives receiving beta-blocker drugs, an additional reduction in standing blood pressure occurred between 60 and 90 minutes after 40 mg phentolamine by mouth. The occurrence of the postural hypotensive effect was delayed in relation to the reported time of peak plasma concentration of unchanged phentolamine. Supine blood pressure and heart rate were unaffected. Phentolamine has no clinically useful anti-hypertensive effect in conjunction with beta-blockers in patients with essential hypertension.

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