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Orthostatic hypotension in de novo Parkinson disease.
Arch Neurol. 2003 Oct; 60(10):1400-4.AN

Abstract

BACKGROUND

It is accepted that orthostatic hypotension is a clinical marker for the diagnosis of multiple system atrophy, but conflicting data indicate that it may also be present in Parkinson disease (PD).

OBJECTIVES

To evaluate the prevalence of autonomic cardiovascular impairment and orthostatic hypotension in a large group of patients with de novo PD, followed up for at least 7 years, to clinically confirm the diagnosis of the disease.

METHODS

During a 2-year recruiting period, 60 untreated patients diagnosed as having idiopathic PD underwent autonomic cardiovascular function evaluation using the Ewing test. Patients subsequently received dopaminergic therapy and their condition was followed up for at least 7 years.

RESULTS

Nine (15%) of 60 patients were excluded from the study because during the follow-up period a parkinsonian syndrome was diagnosed (5 had multiple system atrophy and 4 had progressive supranuclear palsy). Data from 51 patients with PD underwent final statistical analysis and the results were compared with those of 51 age-matched healthy control subjects who had taken the same battery of autonomic tests. A statistically significant difference was found in postural hypotension (P =.02) and deep breathing test results (P =.03) between patients and controls. Seven (14%) of 51 patients with PD and 3 (60%) of 5 patients with multiple system atrophy had a decrease of more than 20 mm Hg in systolic blood pressure on standing.

CONCLUSIONS

Data from this study indicate a high prevalence of sympathetic and parasympathetic failure in patients with de novo PD, and when using a decrease of at least 20 mm Hg in systolic blood pressure, manometric orthostatic hypotension was found in 7 (14%) of the 51 patients with de novo PD.

Authors+Show Affiliations

Department of Neuroscience, Section of Neurology, Movement Disorders Unit, University of Pisa, Pisa, Italy. u.bonuccelli@med.unipi.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

14568810

Citation

Bonuccelli, Ubaldo, et al. "Orthostatic Hypotension in De Novo Parkinson Disease." Archives of Neurology, vol. 60, no. 10, 2003, pp. 1400-4.
Bonuccelli U, Lucetti C, Del Dotto P, et al. Orthostatic hypotension in de novo Parkinson disease. Arch Neurol. 2003;60(10):1400-4.
Bonuccelli, U., Lucetti, C., Del Dotto, P., Ceravolo, R., Gambaccini, G., Bernardini, S., Rossi, G., & Piaggesi, A. (2003). Orthostatic hypotension in de novo Parkinson disease. Archives of Neurology, 60(10), 1400-4.
Bonuccelli U, et al. Orthostatic Hypotension in De Novo Parkinson Disease. Arch Neurol. 2003;60(10):1400-4. PubMed PMID: 14568810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Orthostatic hypotension in de novo Parkinson disease. AU - Bonuccelli,Ubaldo, AU - Lucetti,Claudio, AU - Del Dotto,Paolo, AU - Ceravolo,Roberto, AU - Gambaccini,Gianna, AU - Bernardini,Silvia, AU - Rossi,Giuseppe, AU - Piaggesi,Alberto, PY - 2003/10/22/pubmed PY - 2003/12/3/medline PY - 2003/10/22/entrez SP - 1400 EP - 4 JF - Archives of neurology JO - Arch Neurol VL - 60 IS - 10 N2 - BACKGROUND: It is accepted that orthostatic hypotension is a clinical marker for the diagnosis of multiple system atrophy, but conflicting data indicate that it may also be present in Parkinson disease (PD). OBJECTIVES: To evaluate the prevalence of autonomic cardiovascular impairment and orthostatic hypotension in a large group of patients with de novo PD, followed up for at least 7 years, to clinically confirm the diagnosis of the disease. METHODS: During a 2-year recruiting period, 60 untreated patients diagnosed as having idiopathic PD underwent autonomic cardiovascular function evaluation using the Ewing test. Patients subsequently received dopaminergic therapy and their condition was followed up for at least 7 years. RESULTS: Nine (15%) of 60 patients were excluded from the study because during the follow-up period a parkinsonian syndrome was diagnosed (5 had multiple system atrophy and 4 had progressive supranuclear palsy). Data from 51 patients with PD underwent final statistical analysis and the results were compared with those of 51 age-matched healthy control subjects who had taken the same battery of autonomic tests. A statistically significant difference was found in postural hypotension (P =.02) and deep breathing test results (P =.03) between patients and controls. Seven (14%) of 51 patients with PD and 3 (60%) of 5 patients with multiple system atrophy had a decrease of more than 20 mm Hg in systolic blood pressure on standing. CONCLUSIONS: Data from this study indicate a high prevalence of sympathetic and parasympathetic failure in patients with de novo PD, and when using a decrease of at least 20 mm Hg in systolic blood pressure, manometric orthostatic hypotension was found in 7 (14%) of the 51 patients with de novo PD. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/14568810/Orthostatic_hypotension_in_de_novo_Parkinson_disease_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/vol/60/pg/1400 DB - PRIME DP - Unbound Medicine ER -