Circadian blood pressure and heart rate variations in de novo Parkinson’s disease

Abstract

Altered blood pressure (BP) regulation and heart rate variations are characteristic findings of cardiovascular dysautonomia in patients with Parkinson’s disease (PD). However, these variations had not been adequately investigated. The aim of this study was to investigate the patterns and characteristics of 24-hour BP and heart rate variations in patients with PD. Case-control comparisons of 139 consecutive newly diagnosed patients with PD and 55 age-matched controls were performed. All cases underwent clinical assessments and 24-hour ambulatory BP monitoring. The associations among BP and heart rate variations and parkinsonian motor symptoms were investigated. There were significant differences in the distribution of non-dipping, the percent of nocturnal BP decrease, nighttime BP level, the standard deviation of heart rate, and nocturnal decrease of heart rate between patients with PD and controls. However, these abnormal diurnal BP and heart rate patterns were not associated with parkinsonian motor symptoms and not related to age, gender, or disease duration. In conclusion, this result suggests daily BP and heart rate abnormalities may be one of the circadian cardiovascular autonomic dysfunctions in patients with PD, irrespective of age, disease severity, or motor symptom phenotype.