PPH remains a frequent but under-recognized hemodynamic abnormality in adults with T2DM. Findings presented at the American Heart Association (AHA) 2025 Scientific Session and reported in Circulation examined its relationship with BP variability using 24-hour ambulatory BP monitoring (ABPM).

The evaluation included 121 adults with T2DM (mean age 61.1 years; 50.4% female). PPH was defined as a post-meal systolic BP drop of ≥20 mmHg. PPH occurred in 47.1% of participants, with a mean systolic reduction of 11.6 ± 10.9 mmHg. The largest decline occurred after dinner.

Among those with PPH, 61.4% showed abnormal nocturnal dipping patterns: 28.1% non-dippers, 15.8% reverse dippers and 17.5% extreme dippers. Morning BP surge was more frequent in the PPH group (60.0% vs 39.3%, p=0.046). Daytime systolic BP variability was significantly higher in individuals with PPH (18.2 ± 5.9 vs 15.6 ± 4.2 mmHg, p=0.027).

The magnitude of the post-meal BP drop did not correlate with nighttime dipping percentage or other BP variability measures. Subgroup analyses found no significant associations between PPH and arterial stiffness or cognitive performance (all p>0.1).

These findings show that PPH is common in T2DM and often accompanied by altered BP variability. Longitudinal research is needed to define long-term clinical implications.