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Clinical Autonomic Research
Published in: Clinical Autonomic Research 2/2016

01-04-2016 | Research Article

Supine hypertension in Parkinson’s disease and multiple system atrophy

Authors: Alessandra Fanciulli, Georg Göbel, Jean Pierre Ndayisaba, Roberta Granata, Susanne Duerr, Stefano Strano, Carlo Colosimo, Werner Poewe, Francesco E. Pontieri, Gregor K. Wenning

Published in: Clinical Autonomic Research | Issue 2/2016

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Abstract

Objective

Supine hypertension (SH) is a feature of cardiovascular autonomic failure that often accompanies orthostatic hypotension and may represent a negative prognostic factor in parkinsonian syndromes. Here we investigated the frequency rate as well as the clinical and tilt test correlates of SH in Parkinson’s disease (PD) and multiple system atrophy (MSA).

Methods

197 PD (33 demented) and 78 MSA (24 MSA-Cerebellar, 54 MSA-Parkinsonian) patients who had undergone a tilt test examination were retrospectively included. Clinical-demographic characteristics were collected from clinical records at the time of the tilt test examination.

Results

SH (>140 mmHg systolic, >90 mmHg diastolic) occurred in 34 % of PD patients (n = 66, mild in 71 % of patients, moderate in 27 %, severe in 2 %) and 37 % of MSA ones (n = 29, mild in 55 % of patients, moderate in 17 %, severe in 28 %). No difference was observed in SH frequency between demented versus gender-, age- and disease duration-matched non-demented PD patients, or between patients with the parkinsonian (MSA-P) versus the cerebellar (MSA-C) variant of MSA. In PD, SH was associated with presence of cardiovascular comorbidities (p = 0.002) and greater systolic (p = 0.007) and diastolic (p = 0.002) orthostatic blood pressure fall. Orthostatic hypotension (p = 0.002), and to a lesser degree, lower daily dopaminergic intake (p = 0.01) and use of anti-hypertensive medications (p = 0.04) were associated with SH in MSA.

Interpretation

One-third of PD and MSA patients suffer from mild to severe SH, independently of age, disease duration or stage. In PD, cardiovascular comorbidities significantly contribute to the development of SH, while in MSA, SH appears to reflect cardiovascular autonomic failure.
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Metadata
Title
Supine hypertension in Parkinson’s disease and multiple system atrophy
Authors
Alessandra Fanciulli
Georg Göbel
Jean Pierre Ndayisaba
Roberta Granata
Susanne Duerr
Stefano Strano
Carlo Colosimo
Werner Poewe
Francesco E. Pontieri
Gregor K. Wenning
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research / Issue 2/2016
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-015-0336-4

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