Blood Pressure Patterns in Patients with Parkinson's Disease: A Systematic Review.

Delia Tulbă,Adrian Buzea,Bogdan Ovidiu Popescu,Cristian Băicuș,Liviu Cozma,Paul Bălănescu

doi:10.3390/jpm11020129

Abstract

(1) Background: Cardiovascular autonomic dysfunction is a non-motor feature in Parkinson’s disease with negative impact on functionality and life expectancy, prompting early detection and proper management. We aimed to describe the blood pressure patterns reported in patients with Parkinson’s disease, as measured by 24-h ambulatory blood pressure monitoring. (2) Methods: We conducted a systematic search on the PubMed database. Studies enrolling patients with Parkinson’s disease undergoing 24-h ambulatory blood pressure monitoring were included. Data regarding study population, Parkinson’s disease course, vasoactive drugs, blood pressure profiles, and measurements were recorded. (3) Results: The search identified 172 studies. Forty studies eventually fulfilled the inclusion criteria, with 3090 patients enrolled. Abnormal blood pressure profiles were commonly encountered: high blood pressure in 38.13% of patients (938/2460), orthostatic hypotension in 38.68% (941/2433), supine hypertension in 27.76% (445/1603) and nocturnal hypertension in 38.91% (737/1894). Dipping status was also altered often, 40.46% of patients (477/1179) being reverse dippers and 35.67% (310/869) reduced dippers. All these patterns were correlated with negative clinical and imaging outcomes. (4) Conclusion: Patients with Parkinson’s disease have significantly altered blood pressure patterns that carry a negative prognosis. Ambulatory blood pressure monitoring should be validated as a biomarker of PD-associated cardiovascular dysautonomia and a tool for assisting therapeutic interventions.

Highlights

IntroductionParkinson’s disease (PD) is the second most common neurodegenerative disorder, with a prevalence of 0.3% of the entire population in industrialized countries, reaching up to 4% in the highest age groups [1]
Cardiovascular autonomic dysfunction manifested as abnormal arterial blood pressure (BP) patterns is part of the spectrum of non-motor features of Parkinson’s disease (PD) that occur across all stages and contribute to impaired quality of life, disability and shorter life expectancy [3], requiring proper assessment and management
We focused on 24-h, daytime and nighttime mean values of systolic BP (SBP) and diastolic BP (DBP), BP variability, dipping status, occurrence of orthostatic hypotension (OH) and supine hypertension (SH) as well as high blood pressure (HBP) diagnosis, in an attempt to describe the circadian rhythm and variability of BP in PD

Summary

Introduction

Parkinson’s disease (PD) is the second most common neurodegenerative disorder, with a prevalence of 0.3% of the entire population in industrialized countries, reaching up to 4% in the highest age groups [1]. The biomedical and economic burden of PD is becoming more and more evident with population ageing [1,2]. Cardiovascular autonomic dysfunction manifested as abnormal arterial blood pressure (BP) patterns is part of the spectrum of non-motor features of PD that occur across all stages (including prodromal) and contribute to impaired quality of life, disability and shorter life expectancy [3], requiring proper assessment and management

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