Postprandial Hypotension in Long-Term Care Elderly Patients on Enteral Feeding


Address correspondence to Arthur Leibovitz, Shmuel Harofe Hospital, Geriatric Medical Center, POB 2, Beer-Yaakov, Israel. E-mail:


OBJECTIVES: To examine the prevalence and nature of postprandial hypotension (PPH) in orally fed (OF), nasogastric tube (NGT)-fed, and percutaneous endoscopic gastrostomy (PEG)-fed older people.

DESIGN: Prospective comparative study.

SETTING: Nursing and skilled nursing wards of three geriatrics hospitals.

PARTICIPANTS: Three groups (OF, PEG, NGT) of long-term care patients (50 in each cohort) were enrolled.

MEASUREMENTS: Blood pressure (BP) and heart rate measurements were obtained just before lunch and at 15-minute intervals for 90 minutes after the completion of the meal. The meals were similar in caloric content and composition.

RESULTS: PPH was evidenced in 64 (43%) patients. No significant intergroup (OF, PEG, NGT) differences were present. In 68% of PPH patients, the systolic BP (SBP) drop appeared within 30 minutes, and 70% reached their systolic nadir at 60 minutes. In 31%, the SBP drop was registered on only one measurement, whereas in 25%, the drop was detected on five to six measurements. All parameters were without notable intergroup differences.

CONCLUSION: In enterally fed elderly patients (NGT or PEG), the rate and pattern of PPH are similar and not significantly different from that observed in OF patients.