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Systemic hemodynamic changes in older hypertensive patients after drinking water or eating a meal.

To the Editor:

Raj et al1 recently showed an increase in norepinephrine blood serum levels in patients with autonomic system failure after drinking water. This alteration had been reported previously in healthy subjects. Water ingestion rapidly raises sympathetic response and substantially increases the blood pressure levels, which is an important factor often unrecognized in clinical studies of pressor agents and antihypertensive medications. On the other hand, older hypertensive patients have greater reductions in blood pressure levels after a meal or after oral glucose ingestion than do age matched normotensive people. Postprandial decreases in systolic blood pressure have been found in the elderly patients without overt cardiovascular disease.

We studied the systolic heart function of the 17 elderly hypertensive people after drinking water and eating a meal (10 men and 7 women, mean age: 69 years). All of them had a history of high blood pressure levels for ≥10 years, and they did not have postural hypotension and did not report other comorbidities. Patients with creatinine serum levels <2.5 mg% were included. Heart rate and blood pressure levels were measured by a semiautomated oscillometric device (Dixtal Instruments). The blood pressure values …