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Nondipping in Parkinson's disease
Sita Sommer1, Billur Aral-Becher, Wolfgang Jost
1Department of Neurology, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
Parkinson'S Disease
|September 24, 2011
Summary
Parkinson's disease patients often exhibit a loss of nocturnal blood pressure fall (nondipper), indicating autonomic dysfunction. This finding, identified through 24-hour blood pressure monitoring, is prevalent regardless of orthostatic hypotension or hypertension treatment.
Area of Science:
- Neurology
- Cardiology
- Autonomic Neuroscience
Background:
- Parkinson's disease (PD) is associated with autonomic dysfunction.
- Nocturnal blood pressure fall (nondipping) can be a marker of autonomic dysfunction.
- Orthostatic hypotension is common in PD and involves blood pressure dysregulation.
Purpose of the Study:
- To identify nondipper patients in a cohort of Parkinson's disease patients.
- To investigate the association between nondipping and orthostatic hypotension in PD.
- To assess the impact of arterial hypertension and its treatment on nocturnal blood pressure patterns in PD.
Main Methods:
- 40 Parkinson's disease patients underwent 24-hour ambulatory blood pressure monitoring.
- Nondipping was defined as a nocturnal decrease in mean systolic and diastolic blood pressure <10%.
- Orthostatic hypotension was assessed using Schellong's test; patients' hypertensive status and treatment were recorded.
Main Results:
- A high prevalence of nondipping (88%) was observed in the PD cohort.
- Nondipping was present in 95% of patients with orthostatic hypotension and 79% without.
- Nondipping occurred irrespective of arterial hypertension or antihypertensive medication.
Conclusions:
- 24-hour blood pressure monitoring reveals a high incidence of nondipping in Parkinson's disease patients.
- Nondipping is a common indicator of autonomic dysfunction in PD, present with or without orthostatic hypotension.
- Ambulatory blood pressure monitoring is valuable for detecting autonomic dysfunction markers in Parkinson's disease.
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