Nocturnal blood pressure, non-dipping and psychosis in Parkinson’s Disease

(1) Background: Cardiovascular autonomic dysfunction is a non-motor feature in Parkinson’s disease with negative impact on functionality and life expectancy, prompting early detection and proper management. We aimed to describe the blood pressure patterns reported in patients with Parkinson’s disease, as measured by 24-h ambulatory blood pressure monitoring. (2) Methods: We conducted a systematic search on the PubMed database. Studies enrolling patients with Parkinson’s disease undergoing 24-h ambulatory blood pressure monitoring were included. Data regarding study population, Parkinson’s disease course, vasoactive drugs, blood pressure profiles, and measurements were recorded. (3) Results: The search identified 172 studies. Forty studies eventually fulfilled the inclusion criteria, with 3090 patients enrolled. Abnormal blood pressure profiles were commonly encountered: high blood pressure in 38.13% of patients (938/2460), orthostatic hypotension in 38.68% (941/2433), supine hypertension in 27.76% (445/1603) and nocturnal hypertension in 38.91% (737/1894). Dipping status was also altered often, 40.46% of patients (477/1179) being reverse dippers and 35.67% (310/869) reduced dippers. All these patterns were correlated with negative clinical and imaging outcomes. (4) Conclusion: Patients with Parkinson’s disease have significantly altered blood pressure patterns that carry a negative prognosis. Ambulatory blood pressure monitoring should be validated as a biomarker of PD-associated cardiovascular dysautonomia and a tool for assisting therapeutic interventions.

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Association of depressive symptoms with circadian blood pressure alterations in Parkinson's disease

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2015.10.117 ◽

2016 ◽

Vol 22 ◽

pp. e57

Author(s):

Maria Stella Pisciotta ◽

Davide Liborio Vetrano ◽

Vincenzo Brandi ◽

Maria Rita Lo Monaco ◽

Alice Laudisio ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Depressive Symptoms ◽

Circadian Blood Pressure

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Dissociation between urate and blood pressure in mice and in people with early Parkinson's disease

EBioMedicine ◽

10.1016/j.ebiom.2018.10.039 ◽

2018 ◽

Vol 37 ◽

pp. 259-268 ◽

Cited By ~ 3

Author(s):

Xiqun Chen ◽

Chizoba C. Umeh ◽

Robert E. Tainsh ◽

Danielle D. Feng ◽

Michael Maguire ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Early Parkinson’S Disease

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Myocardial123I-MIBG Uptake and Cardiovascular Autonomic Function in Parkinson’s Disease

Parkinson s Disease ◽

10.1155/2015/805351 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Akira Katagiri ◽

Masato Asahina ◽

Nobuyuki Araki ◽

Anupama Poudel ◽

Yoshikatsu Fujinuma ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Autonomic Function ◽

Low Frequency ◽

Washout Rate ◽

Tilt Test ◽

Mibg Uptake ◽

Cardiovascular Autonomic Function ◽

Frequency Power

Introduction. Patients with Parkinson’s disease (PD) showed reduced myocardial123I-MIBG uptake, which may affect autonomic regulation. We investigated correlation between MIBC accumulation and cardiovascular autonomic function in PD.Methods. We performed myocardial MIBG scintigraphy, heart rate variability (HRV) analysis, and the head-up tilt test (HUT) in 50 PD patients (66.4±7.8years; duration5.5±5.9years). Autonomic function tests were also performed in 50 healthy controls (66.5±8.9years). As HRV parameters, a high-frequency power (HF, 0.15–0.4 Hz), a low-frequency power (LF, 0.04–0.15 Hz), and LF/HF ratio were used.Results. Our PD patients had a significant reduction in LF and HF compared with the controls (P=0.005andP=0.01). In HUT, systolic and diastolic blood pressure falls in the PD group were significantly greater than those in the controls (P=0.02andP=0.02). The washout rate of MIBG was negatively correlated with blood pressure changes during HUT.Conclusion. Our PD patients showed reduced HRV, blood pressure dysregulation, and reduced MIBG accumulation, which was correlated with blood pressure dysregulation. Orthostatic hypotension in PD may be mainly caused by sympathetic postganglionic degeneration.

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