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Suggest Treatment For Postprandial Hypotension
Question: My wife is experiencing the following symptoms. Decreased vision acuity (darkness of vision) ; decreased audio acuity; rapid heartbeat during these episodes, which last between 20 and 40 seconds. The episodes usually occur midday, after she has eaten food to accompany a doctor prescribed dose of 325mg aspirin. 1000mg dose of Vitamin D3, and a generic multivitamin. In addition, she takes prescribed medication for: hypertension ( Amlodipine:Lisinopril) and a statin for cholesterol (Atorvastatin). She has a history of drug and alcohol use and survived an episode in 2012 which affected her speech, and ability to swallow. She smokes still, but has used neither drugs or alcohol since. Earlier in life, she used an estrogen supplement (prescribed and transdermal) to maintain bone density and "youth". I have only been recently become aware of these "blackout" episodes (her words), but I think it is a cry for help from a wonderful woman who dislikes doctor visits nearly as much as I do. Can you help me?
Brief Answer:
Possible postprandial hypotension.
Detailed Answer:
I read your question carefully and I understand your concern about your wife.
If those symptoms occur typically after eating it could be a case of postprandial hypotension, low blood pressure after eating. After an individual eat the digestive system starts its work of digestion and it needs more blood for its activity. As a result more blood is pooled in the intestines and less goes to other organs. Normally the organism has its coping mechanisms, but at times this regulating mechanisms may not function that well and there can be episodes of transitory low blood pressure and supply to the brain, followed by return to normal due to the heart response (rapid heartbeat). It is more likely to occur in people with high blood pressure. So blood pressure measurements before and after meal are necessary.
Management consists in avoiding taking antihypertensive medication before meal, lying down after eating, having low carbohydrates, smaller and more frequent meals.
Other possibility if episodes are not related to eating, might be narrowing of neck blood vessels supplying the brain from more commonly atherosclerosis. Aspirin and atorvastatin is an adequate medication for that, a neck Doppler ultrasound should be done to confirm this possibility.
I remain at your disposal for further questions.
Possible postprandial hypotension.
Detailed Answer:
I read your question carefully and I understand your concern about your wife.
If those symptoms occur typically after eating it could be a case of postprandial hypotension, low blood pressure after eating. After an individual eat the digestive system starts its work of digestion and it needs more blood for its activity. As a result more blood is pooled in the intestines and less goes to other organs. Normally the organism has its coping mechanisms, but at times this regulating mechanisms may not function that well and there can be episodes of transitory low blood pressure and supply to the brain, followed by return to normal due to the heart response (rapid heartbeat). It is more likely to occur in people with high blood pressure. So blood pressure measurements before and after meal are necessary.
Management consists in avoiding taking antihypertensive medication before meal, lying down after eating, having low carbohydrates, smaller and more frequent meals.
Other possibility if episodes are not related to eating, might be narrowing of neck blood vessels supplying the brain from more commonly atherosclerosis. Aspirin and atorvastatin is an adequate medication for that, a neck Doppler ultrasound should be done to confirm this possibility.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you, Doctor. I will have here alter her medication schedule with regard to her mealtimes and see if this relieves/eliminates the problem. If not, we will have to visit with her regular doctor to schedule tests or adjust medications.
Brief Answer:
You're welcome.
Detailed Answer:
I sincerely hope things work out for the best.
You're welcome.
Detailed Answer:
I sincerely hope things work out for the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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