Twenty-four hour non-invasive ambulatory blood pressure and heart rate monitoring in Parkinson's disease
Open accessAbstract
Non-motor symptoms are now commonly recognized in Parkinson's disease (PD) and can include dysautonomia. Impairment of cardiovascular autonomic function can occur at any stage of PD but is typically prevalent in advanced stages or related to (anti-Parkinsonian) drugs and can result in atypical blood pressure (BP) readings and related symptoms such as orthostatic hypotension (OH) and supine hypertension. OH is usually diagnosed with a head-up-tilt test (HUT) or an (active) standing test (also known as Schellong test) in the laboratory, but 24 h ambulatory blood pressure monitoring (ABPM) in a home setting may have several advantages, such as providing an overview of symptoms in daily life alongside pathophysiology as well as assessment of treatment interventions. This, however, is only possible if ABPM is administrated correctly and an autonomic protocol (including a diary) is followed which will be discussed in this review. A 24-h ABPM does not only allow the detection of OH, if it is present, but also the assessment of cardiovascular autonomic dysfunction during and after various daily stimuli, such as postprandial and alcohol dependent hypotension, as well as exercise and drug induced hypotension. Furthermore, information about the circadian rhythm of BP and heart rate (HR) can be obtained and establish whether or not a patient has a fall of BP at night (i.e., "dipper" vs. non-"dipper"). The information about nocturnal BP may also allow the investigation or detection of disorders such as sleep dysfunction, nocturnal movement disorders, and obstructive sleep apnea, which are common in PD. Additionally, a 24-h ABPM should be conducted to examine the effectiveness of OH therapy. This review will outline the methodology of 24 h ABPM in PD, summarize findings of such studies in PD, and briefly consider common daily stimuli that might affect 24 h ABPM.
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In patients with autonomic failure, ABPM allows the assessment of nocturnal hypertension, postprandial hypotension, and exercise- and drug-induced hypotension, as well as monitoring for side effects of antihypotensive regimens and pointing to additional disorders such as sleep apnoea.
“In these patients, ABPM allows the assessment of nocturnal hypertension, postprandial hypotension, and exercise- and drug-induced hypotension, as well as monitoring for side effects of antihypotensive regimens and pointing to additional disorders such as sleep apnoea. 152”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [152]
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- Authors
- Stuebner, E., Vichayanrat, E., Low, D. A., Mathias, C. J., Isenmann, S., & Haensch, C.-A.
- Affiliations
- Witten/Herdecke University (DE)
- St Mary's Hospital (GB)
- Corresponding author
- Haensch, Carl-Albrecht
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2013
- Volume
- 4
- Pages
- 49-49
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC3654335
- OpenAlex
- W2027359268
- Cited by
- 84
- References
- 116
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 7 · 2023: 4 · 2022: 6 · 2021: 9 · 2020: 5 · 2019: 10 · 2018: 12 · 2017: 2 · 2016: 9 · 2015: 4 · 2014: 8 · 2013: 1
- FWCI
- 7.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- Parkinson's disease, orthostatic hypotension, supine hypertension, cardiac autonomic dysfunction, autonomic dysfunction, ambulatory blood pressure monitoring, heart rate monitoring, circadian blood pressure rhythm, nocturnal blood pressure dipping, postprandial hypotension, drug-induced hypotension, sleep disorders, obstructive sleep apnea
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