Guar gum reduces postprandial hypotension in older people

Abstract

<h4>Objective</h4>To determine whether slowing of gastric emptying and glucose absorption with guar gum would reduce the fall in blood pressure after an oral glucose load in older subjects.<h4>Design</h4>A randomized, experimental, cross-over study.<h4>Setting</h4>Department of Nuclear Medicine, Royal Adelaide Hospital, Adelaide, SA, Australia.<h4>Participants</h4>Ten healthy subjects, age 67 to 78.<h4>Measurements</h4>Simultaneous measurements of gastric emptying, blood pressure, blood glucose, serum insulin, and oral glucose absorption (3-O-methyl-D-glucose [3-OMG]) on two occasions after ingestion of 300 mL water containing 50 g glucose and 30 mL lemon juice, 3 g 3-OMG labeled with 99mTc-sulphur colloid; with or without 9 g guar gum. Blood pressure and gastric emptying were monitored for 180 minutes.<h4>Results</h4>The magnitude of the falls in systolic (P = .02), diastolic (P < .05), and mean arterial (P = .05) blood pressure were less, and gastric emptying slower (P < .05), after guar. Blood glucose, insulin, and 3-OMG concentrations were reduced (P < .001 for all) by guar. 3-OMG concentrations were inversely related to the intragastric retention of glucose (r = -0.72, P = .02) and blood pressure was inversely related to 3-OMG (r = -0.64, P < .05) after the drink without guar. The blood glucose concentration was related to 3-OMG (r > 0.64, P < .05).<h4>Conclusion</h4>Guar gum reduces the magnitude of the fall in blood pressure after oral glucose. Slowing of gastric emptying and glucose absorption may represent a novel approach to the treatment of postprandial hypotension.