Postprandial hypotension occurs frequently and current management is suboptimal. Recent studies suggest that the magnitude of the fall in postprandial blood pressure (BP) may be attenuated by gastric distension. The aim of this study was to determine the effect of gastric distension on the hypotensive response to intraduodenal (ID) glucose. Eight healthy subjects (5M, 3F, age 65-76 years) received an ID infusion of either (i) 50g glucose in 300ml saline ('ID glucose') over 60 minutes (t=0-60min), (ii) 50g glucose in 300ml saline over 60 minutes and intragastric (IG) infusion of 500ml water between t=7-10min ('IG water and ID glucose') or (iii) ID saline (0.9%) infusion over 60 minutes and IG infusion of 500ml water ('IG water and ID saline') all followed by ID saline infusion for another 60 minutes (t=60-120min) on three separate days. BP and heart rate (HR) were measured. Gastric emptying (GE) of the IG water was quantified by 2D ultrasonography. Between t=0-60min, systolic and diastolic BP were greater (P<0.05 for both) with 'IG water and ID saline' compared with 'IG water and ID glucose', and less (P<0.05 for both) with 'ID glucose' compared with 'IG water and ID glucose'. These effects were evident at relatively low IG volumes (~300ml). GE was faster with 'IG water and ID saline' when compared with 'IG water and ID glucose'. We conclude that, in healthy older subjects, IG administration of water markedly attenuates the hypotensive response to ID glucose, presumably as a result of gastric distension.