Prevalence of postprandial hypotension in older adults: a systematic review and meta-analysis

Background: Older adults with postprandial hypotension (PPH) increase susceptibility to falls, syncope, stroke, acute cardiovascular diseases and even death. However, the prevalence of this condition varies significantly across studies. We aimed to determine the prevalence of PPH in older adults. 

Methods: Web of Science, PubMed, Cochrane Library, Embase and CINAHL were searched from their inception until February 2023. Search terms included ‘postprandial period’, ‘hypotension’ and ‘postprandial hypotension’. Eligible studies were assessed using the Joanna Briggs Institute tool. Meta-analyses were performed among similar selected studies. 

Results: Thirteen eligible studies were included, and data from 3,021 participants were pooled. The meta-analysis revealed a PPH prevalence of 40.5% [95% confidence interval (CI): 0.290–0.519] in older adults, and this was prevalent in the community (32.8%, 95% CI: 0.078–0.647, n = 1,594), long-term healthcare facility (39.4%, 95% CI: 0.254–0.610, n = 1,062) and geriatrics department of hospitals (49.3%, 95% CI: 0.357–0.630, n = 365). The pooled results showed significant heterogeneity (I² > 90%), partially related to the different ages, sex, pre-prandial systolic blood pressure levels of participants, or the different criteria and methodology used to diagnose PPH. 

Conclusions: PPH is a prevalent condition in older adults. Further research is needed to confirm this result, and priority should be given to establishing international consensus on PPH diagnostic criteria and designing its diagnostic procedure.