Key result
Antiparkinsonian drug regimens showed similar yearly SBP declines (-0.56 vs -1.10 mmHg/year for combined therapy vs levodopa alone) and no correlation with dose increases over 11 years.
Why the study?
Orthostatic hypotension is more frequent in Parkinson's disease patients with longer disease duration and higher disability scores, motivating an evaluation of yearly changes in blood pressure and heart rate and the potential effect of antiparkinsonian drugs.
Does combined levodopa and dopamine agonist therapy versus levodopa monotherapy or increasing levodopa-equivalent daily dose affect long-term age-related changes in resting blood pressure and heart rate in patients with idiopathic Parkinson's disease?
Observational (n=32)
No
Does combined levodopa and dopamine agonist therapy versus levodopa monotherapy or increasing levodopa-equivalent daily dose affect long-term age-related changes in resting blood pressure and heart rate in patients with idiopathic Parkinson's disease?
Patients with Parkinson's disease experience a gradual, significant long-term decline in resting systolic blood pressure over 10+ years that appears driven by disease progression rather than chronic antiparkinsonian drug regimens or dose increases.
Answers are grounded in this paper and cite their sources.
SBP decline in PD appears independent of antiparkinsonian regimens or doses; hypothesis-generating for disease progression effects and should not change practice.
Background Many investigators have confirmed that orthostatic hypotension is more frequent in PD patients with longer disease duration and in those with higher scores on the disability scale. This study evaluated yearly changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) in patients with Parkinson’s disease (PD). Methods Data were collected for the last 16 years from medical records of 32 PD patients. Age-related changes in each group were analyzed by year using mean values of SBP, DBP, and HR obtained at their bi-monthly visits. Results In all PD patients, there was a gradual decrease in SBP with longer disease duration, and mean SBP significantly decreased from Year 7 to 11 compared to the mean values for Year 1 (p < 0.001 or p < 0.01). Regarding the effect of antiparkinsonian drugs, similar changes in SBP (levodopa and dopamine agonists combined therapy: − 0.56 mmHg/year, levodopa monotherapy: − 1.10 mmHg/year, p < 0.01 or p < 0.05) and DBP (levodopa and dopamine agonists combined therapy: − 0.04 mmHg/year, levodopa monotherapy: − 0.30 mmHg/year) were observed with longer disease duration. There were no significant changes in HR in both groups. No significant correlations between the increased change in levodopa-equivalent daily dose (LEDD) from Year 1 to Year 11 and SBP, DBP, or HR were found. Conclusions This is the first study to report age-related changes of BP and HR in individual patients with PD for over 10 years without an association with antiparkinsonian drug use or increases in LEDD.
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Shindo et al. (2026) conducted an observational in Idiopathic Parkinson's disease (n=32). Levodopa and dopamine agonists combined therapy vs. Levodopa monotherapy was evaluated on Yearly change in systolic blood pressure (SBP) over 11 years (p=<0.01 or <0.05). Antiparkinsonian drug regimens showed similar yearly SBP declines (-0.56 vs -1.10 mmHg/year for combined therapy vs levodopa alone) and no correlation with dose increases over 11 years.
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