Objective: Supine (SH) or nocturnal hypertension (NH) are poorly investigated in alpha-synucleinopathies such Parkinson's Disease and Multiple System Atrophy (MSA). These patients have a high prevalence of orthostatic hypotension. Being mostly asymptomatic, SH and NH remain possibly largely underdiagnosed. The objective was to assess the prevalence of NH and pathological nocturnal blood pressure (BP) dipping in a cohort of patients with alpha-synucleinopathies presenting with at least one symptom of orthostatic hypotension on the SCOPA-AUT questionnaire. Design and method: This was a single center retrospective analysis. NH was defined as mean nighttime systolic BP higher or equal to 120 mmHg and/or diastolic BP higher or equal to 70 mmHg. Circadian profiles were classified as dippers (10–20% nocturnal BP fall), non-dippers (<10%), or reverse dippers/risers (nocturnal BP higher than daytime). Descriptive statistics were used. Results: Forty participants (26 men, 14 women) were included. NH was identified in 32 patients (80.0%), of whom 26 (81.3%) with isolated nocturnal hypertension. 21 patients (52.5%) were reverse dippers, 12 (30.0%) non-dippers. Reverse dipping was more prevalent among men (65.4%) than women (28.6%). Reverse dipping was observed in 48.0% of patients with Parkinson's disease and 72.7% of those with multiple system atrophy. Conclusions: The prevalence of undetected NH and abnormal dipping patterns is very high in patients with alpha-synucleinopathies and at least one symptom of orthostatic hypotension. 24-hour ABPM should be considered in these patients.
Loueslati et al. (2026) studied this question.