Abstract: Objective To investigate the effects of different dietary structures on postprandial blood pressure, heart rate, incidences of postprandial hypotension (PPH) and clinical symptoms in the elderly patients with hypertension. Methods A total of 185 elderly patients with primary hypertension admitted to Department of Cardiology, East Hospital Affiliated to Tongji University from June 2021 to October 2022 were enrolled in this study by convenience sampling method.According to the time of admission, 61 cases were enrolled in the high-carbohydrate group, 62 cases enrolled in the high-protein group and 62 cases enrolled in the control group. The high-carbohydrate group received a breakfast with 85% of energy from carbohydrates, the high-protein group received a breakfast with 28% of energy from protein, and the control group received a breakfast with 57% of energy from carbohydrates and 14% of energy from protein. Blood pressure and heart rate were measured before breakfast and 30, 60, 90, 120 minutes after breakfast, and the incidences of PPH and clinical symptoms were recorded and compared among the three groups. Results The postprandial blood pressure in the high-carbohydrate group showed a continuous downward trend from 30 to 120 min after breakfast.The level of systolic blood pressure(SBP)from 60 to 120 min after breakfast in the high-carbohydrate group was significantly lower than that in high-protein group and the control group (P<0.05 or P<0.01).The incidence rate of PPH in the high-carbohydrate group (67.2%) was significantly higher than that in the high-protein group (32.3%) and the control group (41.9%) (P<0.01). Conclusions Reducing carbohydrate content and increasing protein content can reduce the drop of blood pressure after breakfast in the elderly patients with primary hypertension, and can reduce the incidence of PPH.

Key words: dietary structure, hypertension, aged, postprandial hypotension