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Nocturnal hypertension and dysautonomia in patients with Parkinson’s disease: are they related?

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Abstract

Orthostatic hypotension and supine hypertension frequently coexist in Parkinson’s disease (PD) patients, leading to visceral damage and increased mortality rates. The aim of this paper is to analyze the frequency and association of both conditions in a sample of outpatients with PD. A total of 111 patients, diagnosed with PD, were studied. Disease duration, treatment, cardiovascular risk factors, UPDRS I-IV and Scopa Aut scale scores were reported. Subjects underwent 24-h ambulatory blood pressure (BP) monitoring and were assessed for orthostatic hypotension. We compared our results with those published in 17,219 patients using the same protocol and the same type of device. Overall, 71.1 % had no proper circadian rhythm. This frequency was significantly higher than that of the control population (48 %). The prevalence of the nondipper or riser patterns was higher in patients with orthostatic hypotension (77.8 vs. 66.7 %). There was a correlation between nightly increases in diastolic blood pressure and changes in BP during the orthostatic test. Patients taking higher doses of treatment had less decreases in SBP (cc:−0.25; p = 0.007) and DBP (cc:−0.33; p < 0.001) at night, however there was no relation with drug type. The majority of patients with Parkinson’s disease show an altered circadian rhythm of blood pressure. Patients with a non-dipper or riser pattern on 24 h ABPM exhibited a higher prevalence of autonomic disorders (orthostatic hypotension) and received higher doses of dopaminergic treatment. A day–night variation in diastolic blood pressure was the most important marker of these findings.

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Acknowledgments

Funding: this work was supported by Department of Industry of the Basque Government (SAIOTEK S-DI11BF002).

Conflicts of interest

No, there are no competing interests. The research was funded by Department of Industry of the Basque Government, but nobody of authors receive financial gain.

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Authors and Affiliations

  1. Autonomic and Movement Disorders Unit, Neurology Service, Basque Health Service (Osakidetza), Cruces University Hospital, Plaza de Cruces s/n, Barakaldo, 48903, Spain

    Koldo Berganzo, Beatriz Tijero, Elena Lezcano, Iratxe Ugarriza, Roberto Ciordia, J. C. Gómez-Esteban & Juan J. Zarranz

  2. Department of Neurosciences, University of the Basque Country, Leioa, Spain

    Koldo Berganzo, Beatriz Tijero, Elena Lezcano, Iratxe Ugarriza, Roberto Ciordia, J. C. Gómez-Esteban & Juan J. Zarranz

  3. Biscaye Parkinson’s Disease Society, Bilbao, Spain

    Begoña Díez-Arrola

  4. Nuclear Medicine Service, Cruces University Hospital, Barakaldo, Spain

    Verónica Llorens

  5. Department of Neurology, Alava University Hospital, Vitoria-Gasteiz, Spain

    Johanne Somme

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  1. Koldo Berganzo
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  2. Begoña Díez-Arrola
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  3. Beatriz Tijero
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  4. Johanne Somme
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  5. Elena Lezcano
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  6. Verónica Llorens
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  7. Iratxe Ugarriza
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  8. Roberto Ciordia
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  9. J. C. Gómez-Esteban
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  10. Juan J. Zarranz
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Correspondence to Koldo Berganzo.

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Berganzo, K., Díez-Arrola, B., Tijero, B. et al. Nocturnal hypertension and dysautonomia in patients with Parkinson’s disease: are they related?. J Neurol 260, 1752–1756 (2013). https://doi.org/10.1007/s00415-013-6859-5

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  • DOI: https://doi.org/10.1007/s00415-013-6859-5

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