Abstract
ObjectivesBlood pressure (BP) abnormalities have been known in Parkinson's disease (PD) patients. The present study aimed at determining how the BPs of PD patients fluctuate in a day.MethodsA total of 37 PD patients and 44 OD (other disease) patients, all of who were inpatients, were monitored every 30 min by 24-h ambulatory blood pressure monitoring (ABPM).ResultsThe average systolic BP and the number of patients who showed postprandial hypotension were not different between the two groups. However, occurrence of nocturnal hypertension, BP fluctuation of over 100 mmHg in a day and BP of over 200 mmHg were significantly more frequently observed in the PD patients than in the OD patients. In the PD patients, these parameters were not different between those who were suffering from the disease for less than 10 years and those with the disease for 10 years or longer, as well as between those who had a Hoehn–Yahr staging scale of 2–3 and those with a scale of 4–5.ConclusionTwenty-four-hour ABPM, not BP measurement once a day, enables us to determine the actual BP in PD patients. Although hypotension is a severe risk factor for falling and syncope, we emphasize the importance of monitoring rather hypertension and fluctuating BP in PD patients that may lead to a variety of other undesirable conditions. Management of hypotension, hypertension, and BP fluctuation is an important issue in the future.
Highlights
In addition to the motor dysfunctions caused by Parkinson’s disease (PD), nonmotor dysfunctions such as psychiatric symptoms, dementia, sleep disorders, pains, and autonomic dysfunctions have recently been recognized (Ziemssen and Reichmann 2010; Jain 2011)
The statistical analysis with Welch’s t test showed no significant difference in the average blood pressure (BP) between the two groups, but the highest systolic BP during the monitoring was higher in the PD patients than in the other diseases (OD) patients (177 Æ mmHg) (P < 0.05) and the lowest systolic BP was lower in the patients with PD (89 Æ mmHg) than in the patients with OD (97 Æ mmHg) (P < 0.05)
In the present study, the PD patients were found to experience considerable intraday BP fluctuation, and there were observed many cases where the fluctuation was larger than 100 mmHg in terms of the difference between the highest and the lowest systolic blood pressures
Summary
In addition to the motor dysfunctions caused by Parkinson’s disease (PD) (e.g., resting tremor, muscle rigidity, bradykinesia, and postural instability), nonmotor dysfunctions such as psychiatric symptoms, dementia, sleep disorders, pains, and autonomic dysfunctions have recently been recognized (Ziemssen and Reichmann 2010; Jain 2011). Among various autonomic dysfunctions in PD, blood pressure (BP) abnormalities such as orthostatic hypotension (Gross et al 1972; Goldstein et al 2005; Ziemssen and Reichmann 2010; Sharabi and Goldstein 2011), postprandial hypotension (Ejaz et al 2006; Luciano et al 2010), and nocturnal hypertension (Ejaz et al 2006; Ziemssen and Reichmann 2010; Sharabi and Goldstein 2011; Sommer et al 2011) are known. With regard to the BP abnormalities in PD patients, there are several published studies that principally emphasize the importance of monitoring nocturnal hypertension, postprandial hypotension, and orthostatic hypotension (Senard et al 1992; Ejaz et al 2006; Schmidt et al 2009; Stuebner et al 2013).
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