A Ahsan Ejaz1, Indepreet S Sekhon, Sandeep Munjal. 1. Division of Nephrology, Hypertension and Transplantation, University of Florida, P. O. Box 100224, Gainesville, FL 32610, USA.
Abstract
BACKGROUND: Patients with Parkinson's disease frequently present with orthostatic hypotension, prompting testing with 24-h ambulatory blood pressure monitoring (ABPM). The aim of our study was to identify characteristic patterns of blood pressure changes present on ABPM in a series of patients with Parkinson's disease. METHOD: We retrospectively identified 13 patients with Parkinson's disease who had undergone ABPM for evaluation of symptomatic orthostatic hypotension. The ABPM tracings were analyzed for the presence or absence of reversal of circadian pattern, postprandial hypotension, noncompensatory heart rate variability, and average daytime and nocturnal blood pressure values. RESULTS: Reversal of circadian rhythm was identified in 92.3%, postprandial hypotension in 100% and nocturnal hypertension in 100% of the cases. Some 61.5% of the patients exhibited daytime blood pressures in the prehypertensive range, and 23% had blood pressures in the stage 1 hypertension range per JNC 7 classification. CONCLUSION: The characteristic findings on 24-h ABPM in this series of patients with Parkinson's disease were the presence of reversal of circadian rhythm (93%), postprandial hypotension (100%) and nocturnal hypertension (100%).
BACKGROUND:Patients with Parkinson's disease frequently present with orthostatic hypotension, prompting testing with 24-h ambulatory blood pressure monitoring (ABPM). The aim of our study was to identify characteristic patterns of blood pressure changes present on ABPM in a series of patients with Parkinson's disease. METHOD: We retrospectively identified 13 patients with Parkinson's disease who had undergone ABPM for evaluation of symptomatic orthostatic hypotension. The ABPM tracings were analyzed for the presence or absence of reversal of circadian pattern, postprandial hypotension, noncompensatory heart rate variability, and average daytime and nocturnal blood pressure values. RESULTS: Reversal of circadian rhythm was identified in 92.3%, postprandial hypotension in 100% and nocturnal hypertension in 100% of the cases. Some 61.5% of the patients exhibited daytime blood pressures in the prehypertensive range, and 23% had blood pressures in the stage 1 hypertension range per JNC 7 classification. CONCLUSION: The characteristic findings on 24-h ABPM in this series of patients with Parkinson's disease were the presence of reversal of circadian rhythm (93%), postprandial hypotension (100%) and nocturnal hypertension (100%).
Authors: Aleksandar Videnovic; Charleston Noble; Kathryn J Reid; Jie Peng; Fred W Turek; Angelica Marconi; Alfred W Rademaker; Tanya Simuni; Cindy Zadikoff; Phyllis C Zee Journal: JAMA Neurol Date: 2014-04 Impact factor: 18.302