Postprandial Hypotension: Symptoms, Causes, and Treatment (2023)

Postprandial hypotension is when blood pressure significantly drops after eating. This temporary change can cause symptoms such as dizziness, nausea, lightheadedness, and even fainting and related falling injuries. Eating more often throughout the day can help fend these off (low-carb options are best).

Postprandial hypotension is more common in older people and people underlying health conditions, including diabetes and Parkinson's disease. A healthcare provider can diagnose it based on your symptoms and blood pressure readings taken before and after you eat.

This article explains the symptoms, causes, and treatment of postprandial hypotension. It also presents lifestyle changes, such as exercise and eating smaller meals, that can help with the condition.

Postprandial Hypotension: Symptoms, Causes, and Treatment (1)

At-Risk for Postprandial Hypotension

Postprandial hypotension is most commonly seen in older adults. Up to one in three older adults will have some degree of postprandial hypotension, defined as a drop in the systolic blood pressure of up to 20 mmHg within two hours after a meal.

For most of these individuals, the condition is mild and does not trigger symptoms. In some people, however, postprandial hypotension can become quite serious.

Postprandial hypotension is one particular form oforthostatic hypotension (a drop in blood pressure while standing up). It is more likely to affectpeople with high blood pressure, or with certain conditions that impair the autonomicnervous system, such asParkinson's diseaseand type 2diabetes.

Blood Pressure Chart With Readings By Age and Sex

Symptoms of Postprandial Hypotension

People who have postprandial hypotension often experience lightheadedness, dizziness, weakness, or evensyncope (loss of consciousness) when they stand up within one or two hours after eating a meal.

Symptoms tend to be more severe after eating a large meal or one that is heavy in carbohydrates. Consuming alcohol before or during a meal can be another contributor. These symptoms usually resolve within two hours or so after finishing a meal.

Symptoms of Low Blood Pressure

Causes of Postprandial Hypotension

While the cause of postprandial hypotension is not completely understood, it is thought to be related to the pooling of blood in the abdominal organs during digestion. There's evidence that links the condition to the following factors:

  • Meal composition and the type of foods and nutrients eaten
  • Gastric emptying, or how fast food moves from the stomach to the intestines
  • How well (and where) nutrients are absorbed from the digestive tract

As a result of this pooling, the amount of blood available to the general circulation decreases, causing a drop in blood pressure. Standing up increases this effect.

Some blood accumulation in the abdominal organs after a meal is normal since digesting food requires increased blood flow. To compensate, the blood vessels in the legs naturally constrict as a reflex.

(Video) Orthostatic Hypotension (Described Concisely)

With postprandial hypotension, it is thought that it results from either of these conditions:

  • The volume of blood in the gut is exaggerated.
  • The normal constricting of blood vessels in the lower extremities is diminished.

High-Carb Foods

Eating high-carbohydrate meals appears to worsen postprandial hypotension, but proteins and fats also lower the blood pressure in older people after a meal.

Some experts theorize that, in people with postprandial hypotension, insulin or other blood chemicals that are released in response to a high-carb meal may cause excessive dilation of the abdominal blood vessels.

Aging

To some extent, aging is accompanied by an increase in the abdominal blood pooling that normally occurs after a meal. It rarely occurs in younger people, and most older people never develop symptoms from this increased blood pooling.

Those who experience significant symptoms from postprandial hypotension tend to be older.

What Is Alcohol?

Treatment

While there is no specific treatment to eliminate postprandial hypotension, most people can learn to control the symptoms. Treatment involves four elements:

  • Eat smaller, more frequent meals. Eating large meals tends to exaggerate abdominal blood pooling. Smaller meals mean less blood pooling.
  • Drink water before eating. Drinking 12 to 18 ounces of water 15 minutes before eating can offset some of the postprandial response.
  • Avoid high-carbohydrate foods or those that include bread, pasta, and potatoes. (Be sure to do your research as you do your meal planning. Even fruits that are good for you like apples, mangoes, pears, and raisins are high in carbs.)
  • Stay seated. Or, if symptoms are severe, lie down for an hour or two after eating. Abdominal blood pooling tends to dissipate within this time period after a meal.

Some experts also recommend avoiding alcohol, because it relaxes blood vessels and tends to prevent the constriction of blood vessels in the legs that would normally compensate for abdominal blood pooling.

If these measures are insufficient, other therapies commonly used to treat orthostatic hypotension may be helpful. These include:

  • NSAIDs: Taking anonsteroidal anti-inflammatory drugs (NSAIDs)prior to a meal can cause salt to be retained, thereby increasing blood volume.
  • Caffeine: This can cause blood vessels to constrict and may reduce symptoms.
  • Guar gum: This thickening agent may slow the emptying of the stomach after a meal, helping to relieve symptoms.
  • Exercise: Getting plenty of exercise between meals—such as walking—can improve vascular tone and diminish symptoms of postprandial hypotension.

People living withdiastolic heart failurewho are being treated withdiuretics may be more at risk of postprandial hypotension.They may find that withdrawing diuretic foods in the diet, such as certain fruits and herbs, will improve their symptoms.

Foods to Help With Postprandial Hypotension

High-carb foods tend to make postprandial hypotension symptoms worse. Some researchers recommend foods low on the glycemic index for better symptom control. Carrots, chickpeas, and other fruits and vegetables, along with whole grains, may be good choices.

What Is the Glycemic Index?

(Video) What Causes Orthostatic Hypotension? - What You Need To Know Now

If symptoms are severe and cannot be controlled by other measures, subcutaneous injections of octreotide (a drug that behaves like the pancreatic hormone somatostatin) before a meal may help reduce the amount of blood flowing to the intestine. However, this treatment is quite expensive and can cause significant side effects.

Is Hypotension Linked to Hypoglycemia?

People who experience postprandial hypotension often also have diabetes, though it's not always the case. Some people with diabetes may have a neuropathy condition that also contributes to the problem. Researchers have found that acarbose, a drug used to treat type 2 diabetes, also may limit the blood pressure drop after eating, but they suggest more study is needed.

How Hypoglycemia Is Treated

Summary

Since “postprandial” means “after a meal,” it makes sense that postprandial hypotension refers to a dramatic blood pressure drop that occurs after someone stands up after a meal. It's more common in older people, and those with certain diseases, including diabetes.

The blood pressure drop can lead to symptoms of dizziness, lightheadedness, weakness, and even a loss of consciousness. Postprandial hypotension is still poorly understood, but some evidence suggests it's related to the pooling of blood that occurs in abdominal organs during digestion.

Because the blood pools in one place instead of being circulated everywhere in the body, it sets off a drop in blood pressure. Lifestyle changes and, in some cases, medication can help you to keep postprandial hypotension under control.

A Word From Verywell

Postprandial hypotension can become a significant problem, but most people can learn how to control it. Contact a healthcare provider to discuss your symptoms. They can diagnose your condition and explain your treatment options.

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

(Video) What Causes Low Blood Pressure? – Dr.Berg

  1. Harvard Health. Eating Can Cause Low Blood Pressure.

  2. Trahair LG, Horowitz M, Jones KL. Postprandial hypotension: a systematic review. J Am Med Dir Assoc. 2014;15(6):394-409. doi:10.1016/j.jamda.2014.01.011

  3. Borg MJ, Xie C, Rayner CK, Horowitz M, Jones KL, Wu T. Potential for gut peptide-based therapy in postprandial hypotension. Nutrients. 2021;13(8):2826. doi:10.3390/nu13082826

  4. Eschlböck S, Wenning G, Fanciulli A. Evidence-based treatment of neurogenic orthostatic hypotension and related symptoms. J Neural Transm (Vienna). 2017 Dec;124(12):1567-1605. doi:10.1007/s00702-017-1791-y.

  5. Oberoi A, Giezenaar C, Lange K, Jones KL, Horowitz M, Chapman I, et al. Blood pressure and heart rate responses following dietary protein intake in older men. Nutrients. 2022;14(9):1913. doi:10.3390/nu14091913

  6. National Organization for Rare Disorders (NORD). Orthostatic Hypotension.

  7. Agarwal A, Inayat E, Liang F, Wanyan J, Selvaganesh K, Balaji M, et al. The Glycemic Index, Postprandial Hypotension and Cardiovascular Disease. Int J. Hert & Vasclr Syst. 2021;2(1):09‒13. DOI:10.51626/ijhvs.2021.01.00003

  8. Wang B, Zhao J, Zhan Q, Wang R, Liu B, Zhou Y, et al. Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis. Front Cardiovasc Med. 2021 May 20;8:663635. doi:10.3389/fcvm.2021.663635.

Additional Reading

Postprandial Hypotension: Symptoms, Causes, and Treatment (2)

By Richard N. Fogoros, MD
Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology.

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FAQs

What is the best treatment for postprandial hypotension? ›

Treatment of Postprandial Hypotension

Taking a smaller dose of the antihypertensive drugs and eating small, low-carbohydrate meals more frequently may help reduce the effects of this disorder. For some people, walking after a meal helps improve blood flow, but blood pressure may fall when they stop walking.

What is the root cause postprandial hypotension? ›

Failure of blood pressure sensors in the arteries or stretch receptors in the stomach (which alert other parts of the body that eating is under way) can lead to postprandial hypotension, as can diabetes, Parkinson's disease, and other nerve-damaging conditions.

Can postprandial hypotension go away? ›

Postprandial hypotension can be a serious condition, but it's often treatable with lifestyle changes or an adjustment of your anti-hypertensive medications.

What doctor treats postprandial hypotension? ›

A primary care doctor or specialist may diagnose and treat hypotension. The type of specialist most commonly involved is a cardiologist (heart specialist). Other specialists also may be involved, such as surgeons, nephrologists (kidney specialists), neurologists (brain and nerve specialists), or others.

How is postprandial syndrome treated? ›

Many people with IPS may not require medical treatment. Instead, a doctor may recommend they modify their diet to reduce the possibility of experiencing IPS symptoms. The dietary recommendations may include: consuming more lean proteins, such as chicken breast, beans, peas, and lentils.

Does drinking water help postprandial hypotension? ›

Conclusion. Water drinking elicits a rapid pressor response in patients with autonomic failure and can be used to treat orthostatic and postprandial hypotension.

How long does postprandial hypertension last? ›

Postprandial blood pressure usually reaches a nadir within 30–60 minutes in 70% of patients. However, in the remaining 15% of patients, decreases in systolic blood pressure are apparent as late as 75 minutes following the meal (2).

What are three causes of hypotension? ›

Causes of hypotension
  • Emotional stress, fear, insecurity or pain (the most common causes of fainting)
  • Dehydration, which reduces blood volume.
  • The body's reaction to heat, which is to shunt blood into the vessels of the skin, leading to dehydration.
  • Blood donation.
  • Internal bleeding, such as a perforated stomach ulcer.

What foods can cause hypotension? ›

Foods that are high in carbohydrates, particularly processed carbs, tend to digest very quickly relative to other foods. This can lead to sudden drops in blood pressure. A low-carb diet has been shown in some studies to help with off-setting hypotension, especially in older adults.

How common is post prandial hypotension? ›

Postprandial hypotension occurs in up to one third of older people but virtually never occurs in younger people. It is more likely to occur in people who have high blood pressure or disorders that impair the brain centers controlling the autonomic nervous system (which regulates internal body processes).

How do you reverse hypotension? ›

Treatment
  1. Use more salt. Experts usually recommend limiting salt (sodium) because it can raise blood pressure, sometimes dramatically. ...
  2. Drink more water. Fluids increase blood volume and help prevent dehydration, both of which are important in treating hypotension.
  3. Wear compression stockings. ...
  4. Medications.
May 14, 2022

What drug has the highest potential for postural hypotension? ›

Medications at highest risk of OH include cardiovascular drugs (e.g., diuretics, nitrates, β- and α-receptor blockers), and non-cardiovascular drugs (e.g., antidepressants, antipsychotics, trazodone, and BDZs).

What is the first drug of choice for hypotension? ›

Fludrocortisone is recommended as first-line drug therapy. This is a drug that prevents dehydration by causing the kidneys to retain water. This drug boosts the blood volume, which raises the blood pressure.

What happens if hypotension is not treated? ›

Severely low blood pressure can reduce the body's oxygen levels, which can lead to heart and brain damage.

How do you get rid of postprandial hypoglycemia? ›

Eating a balanced diet, including lean and nonmeat sources of protein, and high-fiber foods, including whole grains, fruits and vegetables. Avoiding sugary foods and processed simple carbohydrates, such as white bread or white pasta, especially on an empty stomach. Eating food when drinking alcohol, if you drink.

How do you avoid post prandial slumps? ›

Your physical activity. Beyond helping you sleep better at night, exercise can keep you alert during the day, minimizing the risk of a post-meal slump. Multiple studies have found that regular exercise helps increase energy and reduce fatigue.

Do electrolytes help with hypotension? ›

The salt solution is the best way to restore electrolyte balance and fight dehydration that happens due to low pressure. Some people also prefer licking salt when the pressure drops. Salt helps to retain water in the blood that may bring the pressure back to normal," explains Dr Sonawane.

What is the most common cause of hypotension in elderly? ›

While acute orthostatic hypotension is usually secondary to medication, fluid or blood loss, or adrenal insufficiency, chronic orthostatic hypotension is frequently due to altered blood pressure regulatory mechanisms and autonomic dysfunction.

Can lack of exercise cause postural hypotension? ›

Lack of activity can also cause a condition called orthostatic hypotension, or low blood pressure with changes in body position.

Is postprandial hypotension related to diabetes? ›

Conclusions: Postprandial hypotension is an important symptom of diabetic cardiovascular neuropathy. It is recommended to include postprandial blood pressure measurements in diagnostic algorithm of autonomic nervous system dysfunction in diabetic patients.

Is hypotension a cause of heart failure? ›

Hypotension can be a sign of advanced HF and is associated with worse prognosis. Once HF is manifest, lower BP is associated with a worse prognosis, more commonly so in patients with systolic HF.

What problems can hypotension cause? ›

If your blood pressure drops too low, your body's vital organs do not get enough oxygen and nutrients. When this happens, low blood pressure can lead to shock, which requires immediate medical attention. Signs of shock include cold and sweaty skin, rapid breathing, a blue skin tone, or a weak and rapid pulse.

Can hypotension be cured? ›

If you take medications that affect your blood pressure, your healthcare provider may change your dosage or have you stop taking that medication entirely. If the cause remains a mystery, it's also possible to treat it directly. However, curing hypotension is only possible if there's an underlying cause that's curable.

Which fruit is good for hypotension? ›

Include foods that are high in folates like asparagus, beans, and lentils in your diet. Fruits containing folate can help increase blood pressure. Fruits good for low blood pressure patients include lime, orange, and grapefruit. Also, make sure to have your dose of green leafy vegetables.

What foods to avoid if you have hypotension? ›

Foods with higher salt content are essential for hypotension patients. Therefore, if you are suffering from low BP, you must not consume low-sodium foods like frozen fish, unsalted nuts and seeds, dried peas and beans, etc.

Is banana good for hypotension? ›

Bananas. Bananas contain potassium, which can help manage hypertension. One medium-sized banana contains around 422 milligrams (mg) of potassium. According to the American Heart Association (AHA) , potassium reduces the effects of sodium and alleviates tension in the walls of the blood vessels.

Can dehydration cause postprandial hypotension? ›

Mild dehydration can cause symptoms of orthostatic hypotension, such as weakness, dizziness and fatigue.

How does the body correct hypotension? ›

But your body normally compensates by sending messages to your heart to beat faster and to your blood vessels to constrict. This offsets the drop in blood pressure. If this does not happen, or happens too slowly, postural hypotension results and can lead to fainting.

How long does it take for hypotension to go away? ›

3. Orthostatic Hypotension Usually Resolves Quickly. Most episodes of dizziness from orthostatic hypotension last only seconds. In the vast majority cases, the cardiovascular system belatedly adjusts, adequate blood flow to the brain resumes, and symptoms disappear.

How does the body compensate for hypotension? ›

When your blood pressure drops, your heart rate increases and the blood vessels in other parts of the body constrict (narrow) to help maintain blood pressure. If your heart rate does not increase enough, or if your blood vessels do not constrict enough to maintain blood pressure, your blood pressure will fall.

What causes postural hypotension in the elderly? ›

Progressive orthostatic hypotension is commonly seen in the elderly because of age-related impairment in baroreflex mediated vasoconstriction and chronotropic responses of the heart, as well as to the deterioration of the diastolic filling of the heart (2).

What is a dangerously low blood pressure? ›

What is hypotension? Hypotension is abnormally low blood pressure (lower than 90/60 mm Hg). If your blood pressure gets too low, it can cause dizziness, fainting or death. Low blood pressure is not a condition that is usually treated except if it occurs in the elderly or occurs suddenly.

Which depression meds cause orthostatic hypotension? ›

Orthostatic hypotension is an important complication of imipramine (−26 mmHg of systolic BP) (198–200), amitriptyline, clomipramine (with a decrease of systolic BP of 5–10 mmHg), and its metabolite, desmethylclomipramine (201, 202), especially in older patients (203) and when doses are rapidly up-titrated (Table 2) ( ...

What fluids are given for hypotension? ›

Prolonged hypotension is associated with increased mortality in septic shock. Two main types of fluids are used in shock: crystalloids and colloids. Crystalloid solutions, usually saline solutions or Ringer's lactate, are widely available and relatively inexpensive.

What medications bring blood pressure up? ›

Certain pain and anti-inflammatory medications can cause you to retain water, creating kidney problems and increasing your blood pressure.
...
Pain medications
  • Indomethacin (Indocin, Tyvorbex)
  • Over-the-counter drugs such as aspirin, naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others)
  • Piroxicam (Feldene)

Is chocolate good for low blood pressure? ›

Dark chocolate relaxes blood vessels and improves blood circulation, which can lead to lowered blood pressure levels. Hence, it may not be advisable to eat dark chocolate if you have hypotension or low blood pressure.

Can you live with hypotension? ›

Also called hypotension, low blood pressure is not a problem if you're healthy and show no signs or symptoms of the condition. However, abnormally low blood pressure can cause problems such as dizziness and fainting and can be a sign that other serious conditions, such as heart disease, are present.

Can hypotension be life threatening? ›

Sudden severe drops in your blood pressure starves your body of oxygen. This can lead to damage of the heart, brain, and other organs. This type of low blood pressure can be life threatening if not treated right away.

Can low blood pressure cause a stroke? ›

A less common cause of ischemic stroke occurs when blood pressure becomes too low (hypotension), reducing blood flow to the brain. This usually occurs with narrowed or diseased arteries. Low blood pressure can result from a heart attack, large loss of blood or severe infection.

What is the fastest way to cure hypotension? ›

Treatment
  1. Use more salt. Experts usually recommend limiting salt (sodium) because it can raise blood pressure, sometimes dramatically. ...
  2. Drink more water. Fluids increase blood volume and help prevent dehydration, both of which are important in treating hypotension.
  3. Wear compression stockings. ...
  4. Medications.
May 14, 2022

What is the drug of choice for hypotension? ›

Agents that can be used alone or in combination include calcium channel antagonists (e.g. nicardipine), beta-adrenoceptor antagonists (beta-blockers) [e.g. propranolol, esmolol] and fenoldopam. Agents that are mainly used adjunctively include ACE inhibitors and clonidine.

What do doctors do for low blood pressure? ›

Depending on your symptoms, treatment may include drinking more fluids to prevent dehydration, taking medicines to raise your blood pressure, or adjusting medicines that cause low blood pressure. Your doctor may talk to you about lifestyle changes, including changing what and how you eat and how you sit and stand up.

Can you reverse hypotension? ›

For many people, chronic low blood pressure can be effectively treated with diet and lifestyle changes. Depending on the cause of your symptoms, your doctor may tell you to increase your blood pressure by making these simple changes: Eat a diet higher in salt. Drink lots of nonalcoholic fluids.

What causes sudden dropping blood pressure? ›

Sudden drops in blood pressure most commonly occur in someone who's rising from a lying down or sitting position to standing. This kind of low blood pressure is known as postural hypotension or orthostatic hypotension. Another type of low blood pressure can occur when someone stands for a long period of time.

How do I keep blood pressure from dropping when I stand up? ›

Symptoms of low blood pressure are often triggered by dehydration, so drinking more water may help. Extra fluids increase blood volume and prevent dehydration. In some cases, adding salt to your diet can help, too.

How do you test for postural hypotension? ›

1 Have the patient lie down for 5 minutes. 2 Measure blood pressure and pulse rate. 3 Have the patient stand. 4 Repeat blood pressure and pulse rate measurements after standing 1 and 3 minutes.

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