A case of postprandial hypotension in an individual with cervical spinal cord injury: treatment with acarbose

Spinal Cord Series and Cases, 2019 · DOI: https://doi.org/10.1038/s41394-019-0220-x · Published: August 19, 2019

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

Postprandial hypotension (PPH) is a drop in blood pressure after eating, possibly due to increased blood flow to the digestive system. People with spinal cord injuries (SCI) and autonomic dysfunction might be susceptible to PPH. This paper presents a case where acarbose, a drug that slows glucose absorption, was used to treat PPH in a woman with cervical SCI. The patient experienced improvement in her symptoms after treatment. The authors suggest that PPH may be underdiagnosed in individuals with SCI due to autonomic dysfunction and propose that clinicians should be aware of this possibility.

Study Duration

5 years of worsening symptoms

Participants

One 62-year-old woman with cervical SCI

Evidence Level

Case Report

Key Findings

1
Acarbose effectively managed PPH symptoms and attenuated blood pressure drops in a woman with long-standing cervical SCI.
2
The patient experienced an immediate improvement in symptoms and attenuation of postmeal drops in blood pressure after starting acarbose.
3
The case suggests PPH may be more prevalent in individuals with SCI than currently recognized, particularly those with higher-level injuries.

Research Summary

This case report describes a 62-year-old woman with cervical SCI who experienced postprandial hypotension (PPH). She presented with lightheadedness, visual disturbances and neck pain. Treatment with acarbose, which slows glucose absorption, led to a significant improvement in her PPH symptoms and a reduction in postmeal blood pressure drops. The authors suggest that PPH may be underdiagnosed in SCI patients and recommend that clinicians be aware of the possibility of PPH in this population.

Practical Implications

Increased Awareness

Clinicians should consider PPH in SCI patients presenting with postmeal symptoms.

Acarbose as Treatment Option

Acarbose can be a viable treatment option for PPH in SCI patients, especially those with diabetes.

Further Research Needed

Further research is needed to determine the prevalence of PPH in the SCI population.

Study Limitations

1
Single case study limits generalizability.
2
The patient was also taking pindolol, which may have influenced her heart rate response.
3
Other potential causes of postural hypotension were not fully evaluated.

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