Key result
Reverse dipping in Parkinson's disease patients was associated with a significantly higher left ventricular mass index compared to non-reverse dippers (90.2 vs. 77.4 g/m2; P=0.04).
Why the study?
Patients with Parkinson's disease often present with reverse dipping and nocturnal hypertension, but cardiac alterations in these patients compared to non-reverse dippers and essential hypertensive patients had not been evaluated.
Does a reverse dipping blood pressure pattern associate with increased left ventricular mass and hypertrophy in patients with Parkinson's disease?
Observational (n=78)
Does a reverse dipping blood pressure pattern associate with increased left ventricular mass and hypertrophy in patients with Parkinson's disease?
Absolute Event Rate: 90.2% vs 77.4%
p-value: p=0.04
Reverse dipping and nocturnal hypertension in Parkinson's disease patients are associated with increased left ventricular mass and hypertrophy, comparable to levels seen in essential hypertensive patients.
May flag higher LVH risk in Parkinson's disease; hypothesis-generating and should not yet change practice.
OBJECTIVE: Patients with autonomic neuropathy associated with Parkinson's disease often show reverse dipping pattern/nocturnal hypertension at 24-h ambulatory blood pressure (BP) monitoring (24-h ABPM) and diurnal orthostatic hypotension. The aim of the study was to evaluate cardiac alterations in Parkinson's disease patients with reverse dipping, in comparison with non-reverse dippers Parkinson's disease and essential hypertensive patients. METHODS: A total of 26 consecutive Parkinson's disease patients with reverse dipping at 24-h ABPM and no previous history of hypertension were compared with 26 non-reverse Parkinson's disease patients matched for age, sex and 24-h mean BP, and 26 essential hypertensive patients matched for nighttime mean BP. None of the Parkinson's disease patients suffered from cardiovascular diseases or were treated with antihypertensive or antihypotensive drugs. Reverse dipping was defined by a systolic day-night BP difference less than 0% at 24-h ABPM. Left ventricular (LV) hypertrophy was defined by a LV mass index at least 115 g/m in men and at least 95 g/m in women. RESULTS: LV mass, indexed for BSA, was significantly higher in reverse dipping than non-reverse Parkinson's disease patients (respectively 90.2 ± 25.3 vs. 77.4 ± 13.3 g/m, P = 0.04), and was similar to essential hypertensive patients (91.6 ± 24.8, P = 0.92). LV hypertrophy was detected in five reverse dipping Parkinson's disease patients and four hypertensive patients, but was not present in non-reverse Parkinson's disease patients (P = 0.046). Nocturnal BP values, nocturnal BP load, weighted BP variability and age were found to correlate with the increased LV mass index. CONCLUSION: Reverse dipping and nocturnal hypertension are related to higher LV mass and increased prevalence of LV hypertrophy in Parkinson's disease patients.
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Stefano et al. (2019) conducted an observational in Parkinson's disease (n=78). Reverse dipping vs. Non-reverse dipping was evaluated on Left ventricular mass index (p=0.04). Reverse dipping in Parkinson's disease patients was associated with a significantly higher left ventricular mass index compared to non-reverse dippers (90.2 vs. 77.4 g/m2; P=0.04).
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