The Effects of Acarbose on the Postprandial Hypotensive Response in Older Adults.

Postprandial hypotension (PPH) is defined as a postprandial decline in systolic blood pressure (SBP) of 20 mm of Hg. Some have recommended the use of acarbose (an alpha-glucosidase inhibitor) as a potential therapy for PPH based exclusively on studies of older adults with diabetes. Using a randomized placebo-controlled design, 43 older adults (23 women, 20 men, mean age 77.1 ± 0.9 years) were recruited from geriatric medicine outpatient clinics in an academic centre. Although the average decrease in SBP during the meal test was significantly attenuated in the acarbose group (standardized β  = 0.724 ± 0.286, p = 0.017), the acarbose group experienced significantly more PPH events (standardized β  = 0.593 ± 0.279, p = 0.040). Although acarbose attenuated the mean decrease in SBP during the meal test, it did not reduce the actual number of PPH events recorded in a general population of older adults.ClinicalTrials.gov ID NCT01914133.