Prevention of Postprandial Hypotension with Somatostatin

Excerpt

Patients with autonomic neuropathy may develop profound hypotension after eating (1, 2). We have recently seen a patient whose mean blood pressure fell 60 to 80 mm Hg each day after breakfast. We were unable to prevent his postprandial hypotension with fludrocortisone, indomethacin, or dihydroergotamine. Pretreatment with intravenous somatostatin, however, prevented the postprandial decrease in blood pressure.

A 70-year-old white man had chronic alcoholism, autonomic neuropathy, hypoaldosteronism, esophageal stricture, and recurrent gastritis. He had dizziness and blurred vision on standing upright or after a meal. His blood pressure was 150/70 mm Hg when supine and 65/35 mm Hg when upright.