Heart Health High Blood Pressure Low Blood Pressure An Overview of Postprandial Hypotension By Richard N. Fogoros, MD Richard N. Fogoros, MD Facebook LinkedIn Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Learn about our editorial process Updated on October 21, 2022 Medically reviewed by Yasmine S. Ali, MD, MSCI Medically reviewed by Yasmine S. Ali, MD, MSCI Facebook LinkedIn Twitter Yasmine S. Ali, MD, MSCI, is a board-certified preventive cardiologist and lipidologist. Dr. Ali is also an award-winning writer. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Vulnerability in Older Adults Symptoms Causes Treatment 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. Vanessa Clara Ann Vokey / Getty Images 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 of orthostatic hypotension (a drop in blood pressure while standing up). It is more likely to affect people with high blood pressure, or with certain conditions that impair the autonomic nervous system, such as Parkinson's disease and type 2 diabetes. Blood Pressure Chart With Readings By Age and Sex Symptoms of Postprandial Hypotension People who have postprandial hypotension often experience lightheadedness, dizziness, weakness, or even syncope (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 eatenGastric emptying, or how fast food moves from the stomach to the intestinesHow 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. 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 a nonsteroidal 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 with diastolic heart failure who are being treated with diuretics 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? 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. Harvard Health. Eating Can Cause Low Blood Pressure. 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 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 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. 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 National Organization for Rare Disorders (NORD). Orthostatic Hypotension. 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 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 Mills PB, Fung CK, Travlos A, Krassioukov A. Nonpharmacologic Management of Orthostatic Hypotension: A Systematic Review. Arch Phys Med Rehabil. 2015;96(2):366-375.e6. doi:10.1016/j.apmr.2014.09.028. 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. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit