Key result
A reverse dipping blood pressure pattern was present in 53.5% of Parkinson's disease patients without prior abnormal BP and was significantly associated with orthostatic hypotension (P<0.001).
Why the study?
Cardiovascular dysautonomia can be present across Parkinson's disease stages, prompting investigation into 24-h ambulatory BP monitoring characteristics and cardiovascular dysautonomia frequency in patients without abnormal BP history.
What is the frequency of cardiovascular dysautonomia and characteristics of 24-h ambulatory BP monitoring in Parkinson's disease patients without an abnormal BP history?
Cross-Sectional (n=101)
Yes
What is the frequency of cardiovascular dysautonomia and characteristics of 24-h ambulatory BP monitoring in Parkinson's disease patients without an abnormal BP history?
p-value: p=<0.001
In Parkinson's disease patients without a history of abnormal BP, over half exhibit a reverse dipping pattern on 24-hour ambulatory monitoring, which is a useful indicator for suspecting orthostatic hypotension.
ABPM may aid dysautonomia detection in normotensive Parkinson's; cross-sectional data leaves open prospective validation and outcome impact.
OBJECTIVES: Cardiovascular dysautonomia can be present at early, late and even prodromal stages of Parkinson's disease. This study aimed to describe the characteristics of 24-h ambulatory blood pressure (BP) monitoring and investigate the frequency of cardiovascular dysautonomia in Parkinson's disease without an abnormal BP history. METHODS: Parkinson's disease patients without history of abnormal BP were consecutively enrolled from three Chinese centres, on whom office BP measurement, neurological evaluations and 24-h ambulatory BP monitoring were performed. RESULTS: Totally, 101 Parkinson's disease patients (42.6% women) with an average age of 66.6 ± 8.2 years were included in our cohort, and data analysis revealed that 26 (25.74%) patients suffered from orthostatic hypotension, among whom 18 (69.23%) were symptomatic. Patients with orthostatic hypotension compared with those without had significantly higher nocturnal SBP level, and more severe nonmotor symptoms, autonomic dysfunction and cognitive impairment. Further, 54 out of 101 (53.47%) individuals had a reverse dipping pattern in SBP and/or DBP. Reverse dippers had more cases of orthostatic hypotension (P < 0.001), and more severe nonmotor symptoms. SBP dipping ratio of less than -2.98% generated 76.9% of sensitivity, 69.3% of specificity, 46.5% of positive predictive value (PPV), 89.7% of negative predictive value (NPV) and 77.4% of accuracy, while diastolic dipping ratio of less than -1.80% generated 76.9% of sensitivity, 70.7% specificity, 47.6% of PPV, 89.8% of NPV and 77.8% of accuracy for suspecting orthostatic hypotension. CONCLUSION: Orthostatic hypotension can occur in one-fourth Parkinson's disease patients without abnormal BP history, and reverse dipping was present in more than half of patients with Parkinson's disease. Reverse dipping pattern was helpful to suspect orthostatic hypotension.
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Chen et al. (2020) conducted a cross-sectional in Parkinson's disease (n=101). Reverse dipping pattern in SBP and/or DBP vs. Non-reverse dipping pattern was evaluated on Orthostatic hypotension (p=<0.001). A reverse dipping blood pressure pattern was present in 53.5% of Parkinson's disease patients without prior abnormal BP and was significantly associated with orthostatic hypotension (P<0.001).
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