scholarly journals Nondipping in Parkinson's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Sita Sommer ◽  
Billur Aral-Becher ◽  
Wolfgang Jost

Objective. The aim of this study was to identify patients with Parkinson's disease who showed loss or decrease of nocturnal blood pressure fall (nondipper patients) as a marker of autonomic dysfunction. Presence or absence of orthostatic hypotension was considered to investigate whether alterations in circadian blood pressure pattern are associated with posture-related dysregulation of blood pressure.Methods. 40 patients with Parkinson's disease underwent 24-hour blood pressure monitoring. 21 patients were diagnosed with arterial hypertension and received anti-hypertensive drugs. Nondipper patients were defined as having nocturnal decrease of mean systolic and diastolic blood pressure less than 10%. Presence or absence of orthostatic hypotension was determined by Schellong's test.Results. We identified 35 nondipper patients (88%). Nondipping was detected in 20 patients with orthostatic hypotension (95%) and in 15 patients without orthostatic hypotension (79%). 18 patients with hypertensive and 22 patients with normal blood pressure values were detected.Conclusions. In conclusion 24-hour blood pressure monitoring showed a high prevalence of nondipping in 40 patients with Parkinson's disease with and without orthostatic hypotension independent of coexisting arterial hypertension and antihypertensive treatment. 24-hour blood pressure monitoring may be useful to identify non-dipping as a marker of autonomic dysfunction in patients with Parkinson's disease.

2019 ◽  
Vol 42 (10) ◽  
pp. 1552-1560 ◽  
Author(s):  
Fabrizio Vallelonga ◽  
Alberto Romagnolo ◽  
Aristide Merola ◽  
Gabriele Sobrero ◽  
Cristina Di Stefano ◽  
...  

2021 ◽  
Vol 11 (2) ◽  
pp. 129
Author(s):  
Delia Tulbă ◽  
Liviu Cozma ◽  
Paul Bălănescu ◽  
Adrian Buzea ◽  
Cristian Băicuș ◽  
...  

(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.


2020 ◽  
Vol 111 (6) ◽  
Author(s):  
Ramón C. Hermida ◽  
Artemio Mojón ◽  
José R. Fernández ◽  
Alfonso Otero ◽  
Juan J. Crespo ◽  
...  

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1221
Author(s):  
Marek Koudelka ◽  
Eliška Sovová

Background and Objectives: This study aims to determine prevalence of masked uncontrolled hypertension (MUH) in frail geriatric patients with arterial hypertension and thus show the role of ambulatory blood pressure monitoring (ABPM) since hypertension occurs in more than 80% of people 60+ years and cardiovascular diseases are the main cause of death worldwide. Despite modern pharmacotherapy, use of combination therapy and normal office blood pressure (BP), patients’ prognoses might worsen due to inadequate therapy (never-detected MUH). Materials and Methods: 118 frail geriatric patients (84.2 ± 4.4 years) treated for arterial hypertension with office BP < 140/90 mmHg participated in the study. 24-h ABPM and clinical examination were performed. Results: Although patients were normotensive in the office, 24-h measurements showed that BP values in 72% of hypertensives were not in the target range: MUH was identified in 47 (40%) patients during 24 h, in 48 (41%) patients during daytime and nocturnal hypertension in 60 (51%) patients. Conclusions: ABPM is essential for frail geriatric patients due to high prevalence of MUH, which cannot be detected based on office BP measurements. ABPM also helps to detect exaggerated morning surge, isolated systolic hypertension, dipping/non-dipping, and set and properly manage adequate treatment, which reduces incidence of cardiovascular events and contributes to decreasing the financial burden of society.


2021 ◽  
Vol 15 (54) ◽  
pp. 448-456
Author(s):  
Josicleiton Morais de Lima ◽  
Amanda Camboim De Sá Santos ◽  
João Paulo Soares Rafael ◽  
Victor Lucas Avelino Galindo ◽  
Milena Nunes Alves de Sousa

  Resumo: O objetivo deste trabalho foi identificar as principais dificuldades encontradas no acompanhamento dos portadores de Hipertensão Arterial Sistêmica (HAS) utilizando a ferramenta MRPA, bem como as vantagens e eficácia do tratamento ao hipertenso. Foi realizado o levantamento dos artigos científicos nas bases de dados eletrônicas Google Acadêmico e Scientific Electronic Library Online. Após a inserção dos critérios de inclusão e exclusão foram selecionados dez estudos publicados entre 2005 e 2020 para compor a amostra. As dificuldades apontadas na literatura foram: o declínio do uso da ferramenta em longo prazo, dificuldade no manuseio do aparelho, número insuficiente de medidas pelos pacientes dos estudos e indução de estresse e ansiedade nos pacientes. Além disso, foram averiguadas vantagens do uso da ferramenta e a eficácia desse tipo de monitorização no tratamento ao portador de HAS. A ferramenta MRPA é eficaz no diagnóstico e acompanhamento de hipertensos, e para melhor usufruir dessa estratégia, é preciso que os profissionais estejam atentos às dificuldades apontadas e solucioná-las.   


2017 ◽  
Vol 95 (7) ◽  
pp. 581-585
Author(s):  
Igor N. Bokarev ◽  
P. A. Dulin ◽  
Yu. V. Ovchinnikov ◽  
V. B. Simonenko

Arterial hypertension (AH) is one of the most common diseases. Despite numerous studies, many problems related to this pathology remain to be elucidated. The modern classifications of AHare contradictory and true causes of elevated blood pressure (BP) are unknown. There are no methods for diagnostics of early stages of AH nor is there adequateunderstanding of what hypertensive crises are, how they are to be classified and why they develop. Pathomorphosis of AH is practically unexplored. There are no efficient medications and therapies for the radical treatment of AH. The authors propose classification of hypertensive crisis, hypertensive disease, and symptomatic AH. It is recommended to use 24-hour blood pressure monitoring in all AH patients. New approaches to diagnostics of early stages of AH are proposed.


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