Reduced resting beat-to-beat blood pressure variability in patients with Parkinson's disease

Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects both motor and non-motor functions, including autonomic regulation. In the cardiovascular system, autonomic dysfunction may result in blood pressure (BP) abnormalities, such as altered variability. Therefore, the present study aimed to test the hypothesis that patients with PD exhibit increased resting beat-to-beat blood pressure variability (BPV) compared to healthy controls.

Beat-to-beat heart rate (via electrocardiography) and BP (via photoplethysmography) were continuously recorded in 19 patients with PD, 15 age-matched older adults, and 19 young adults. Cardiac output (CO) and total peripheral resistance (TPR) were estimated using the ModelFlow method. BPV was assessed using several indices, including the standard deviation (SD) and average real variability (ARV).

Compared to both older and younger control groups, patients with PD exhibited lower ARV values for systolic (1.6 ± 0.5 vs. 2.3 ± 0.5 and 3.1 ± 1.1 mm Hg, P = 0.001), diastolic (0.9 ± 0.2 vs. 1.1 ± 0.4 and 1.5 ± 0.6 mm Hg, P = 0.001), and mean (0.9 ± 0.2 vs. 1.2 ± 0.4 and 1.5 ± 0.5 mm Hg, P = 0.001) BP. In addition, patients with PD showed reduced ARV in TPR compared to the older control group (0.5 ± 0.2 vs. 0.7 ± 0.7 mm Hg/L/min, P = 0.045). However, ARV in CO did not differ significantly between PD patients and older adults (119 ± 68 vs. 136 ± 48 mL/min, P = 0.806). Similar patterns were observed when using other BPV indices.

These findings suggest that Parkinson's disease may lead to a reduction in beat-to-beat blood pressure variability, potentially driven by changes in total peripheral resistance rather than cardiac output.