O-017: Association of circadian blood pressure alterations and disease features 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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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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Acute Cardiovascular Responses to Self-selected Intensity Exercise in Parkinson's Disease

International Journal of Sports Medicine ◽

10.1055/a-1529-6480 ◽

2021 ◽

Author(s):

Hélcio Kanegusuku ◽

Gabriel Grizzo Cucato ◽

Paulo Longano ◽

Erika Okamoto ◽

Maria Elisa Pimentel Piemonte ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Heart Rate ◽

Parkinson's Disease ◽

Pulse Wave ◽

Augmentation Index ◽

Cardiovascular Responses ◽

Cycle Ergometer ◽

Control Session ◽

Wave Analysis

AbstractParkinson’s disease patients frequently present cardiovascular dysfunction. Exercise with a self-selected intensity has emerged as a new strategy for exercise prescription aiming to increase exercise adherence. Thus, the current study evaluated the acute cardiovascular responses after a session of aerobic exercise at a traditional intensity and at a self-selected intensity in Parkinson’s disease patients. Twenty patients (≥ 50 years old, Hoehn & Yahr 1–3 stages) performed 3 experimental sessions in random order: Traditional session (cycle ergometer, 25 min, 50 rpm, 60–80% maximum heart rate); Self-selected intensity: (cycle ergometer, 25 min, 50 rpm with self-selected intensity); and Control session (resting for 25 min). Before and after 30 min of intervention, brachial and central blood pressure (auscultatory method and pulse wave analysis, respectively), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave analysis) were evaluated. Brachial and central systolic and diastolic blood pressure, heart rate, and the augmentation index increased after the control session, whereas no changes were observed after the exercise sessions (P<0.01). Pulse wave velocity and cardiac autonomic modulation parameters did not change after the three interventions. In conclusion, a single session of traditional intensity or self-selected intensity exercises similarly blunted the increase in brachial and central blood pressure and the augmentation index compared to a non-exercise control session in Parkinson’s disease patients.

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Blood pressure lability is associated with subcortical atrophy in early Parkinson's disease

Journal of Hypertension ◽

10.1097/hjh.0000000000002505 ◽

2020 ◽

Vol 38 (10) ◽

pp. 2043-2049

Author(s):

Sang-Won Yoo ◽

Eunkyeong Yun ◽

Mirim Bang ◽

Uicheul Yoon ◽

Ji-Yeon Yoo ◽

...

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Early Parkinson’S Disease ◽

Blood Pressure Lability

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Blunted cardiovascular responses to exercise in Parkinson’s disease patients: role of the muscle metaboreflex

Journal of Neurophysiology ◽

10.1152/jn.00308.2018 ◽

2018 ◽

Vol 120 (4) ◽

pp. 1516-1524 ◽

Cited By ~ 9

Author(s):

Jeann L. Sabino-Carvalho ◽

André L. Teixeira ◽

Milena Samora ◽

Maurício Daher ◽

Lauro C. Vianna

Keyword(s):

Blood Pressure ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cold Pressor Test ◽

Peripheral Resistance ◽

Cold Pressor ◽

Cardiovascular Responses ◽

Group Differences ◽

Muscle Metaboreflex ◽

Pressor Test

Patients with Parkinson’s disease (PD) exhibit attenuated cardiovascular responses to exercise. The underlying mechanisms that are potentially contributing to these impairments are not fully understood. Therefore, we sought to test the hypothesis that patients with PD exhibit blunted cardiovascular responses to isolated muscle metaboreflex activation following exercise. For this, mean blood pressure, cardiac output, and total peripheral resistance were measured using finger photoplethysmography and the Modelflow method in 11 patients with PD [66 ± 2 yr; Hoehn and Yahr score: 2 ± 1 a.u.; time since diagnosis: 7 ± 1 yr; means ± SD) and 9 age-matched controls (66 ± 3 yr). Measurements were obtained at rest, during isometric handgrip exercise performed at 40% maximal voluntary contraction, and during postexercise ischemia. Also, a cold pressor test was assessed to confirm that blunted cardiovascular responses were specific to exercise and not representative of generalized sympathetic responsiveness. Changes in mean blood pressure were attenuated in patients with PD during handgrip (PD: ∆25 ± 2 mmHg vs. controls: ∆31 ± 3 mmHg; P < 0.05), and these group differences remained during postexercise ischemia (∆17 ± 1 mmHg vs. ∆26 ± 1 mmHg, respectively; P < 0.01). Additionally, changes in total peripheral resistance were attenuated during exercise and postexercise ischemia, indicating blunted reflex vasoconstriction in patients with PD. Responses to cold pressor test did not differ between groups, suggesting no group differences in generalized sympathetic responsiveness. Our results support the concept that attenuated cardiovascular responses to exercise observed in patients with PD are, at least in part, explained by an altered skeletal muscle metaboreflex. NEW & NOTEWORTHY Patients with Parkinson’s disease (PD) presented blunted cardiovascular responses to exercise. We showed that cardiovascular response evoked by the metabolic component of the exercise pressor reflex is blunted in patients with PD. Furthermore, patients with PD presented similar pressor response during the cold pressor test compared with age-matched controls. Altogether, our results support the hypothesis that attenuated cardiovascular responses to exercise observed in patients with PD are mediate by an altered skeletal muscle metaboreflex.

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