We aimed to investigate whether and how often changes in blood pressure (BP) were occurring in relation to eating in a large sample of acute stroke patients. BP was measured non-invasively at 5-min intervals from 10 min before the meal, throughout the meal and for 10 min after completion of the meal while the patient was seated. Stroke patients (n = 93) had a higher BP at baseline than both elderly (n = 49) and young controls (n = 20), which was statistically significant. There were no significant differences in the magnitude of change of BP during the meal between the three groups. Compared with the average baseline BP recordings, stroke and elderly control patients, but not young healthy control subjects, had a significant fall in average BP recordings by 3-4 mm Hg. Falls of ! 10 mm Hg in systolic BP immediately after finishing the meal were observed in a similar frequency of stroke (26%) and elderly patients (22%) and in a small number of young controls (10%). These data suggest that acute stroke and elderly patients have similar changes in BP during and immediately after eating. Although reassuring, these results may have greater implications in patients with acute ischaemic stroke, although it is unclear whether changes in BP of this magnitude and duration might influence the fate of the penumbral brain tissue and thus the clinical outcome after stroke. Copyright (C) 2001 S. Karger AG, Basel.