Age‐related changes in blood pressure and heart rates of patients with Parkinson's disease

Abstract

This study evaluated yearly changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rates (HR) for patients with Parkinson's disease (PD). Data were collected for the last 10 years from medical records of 28 PD patients and 30 non‐PD patients with other neurological disorders. Age‐related changes in each group were analyzed by year using mean values of SBP, DBP, and HR obtained at their bi‐monthly visits. In results, PD patients had a gradual decrease in SBP with longer disease duration, and mean SBP significantly decreased from Year 7–11 compared to the mean values for Year 1 (p < .001 or p < .01). In non‐PD patients, mean SBP significantly increased from Year 4–11 compared to the mean values for Year 1 (p < .001 or p < .01). This is the first study to report age‐related changes of BP in individual patients with PD over 10 years.

Is systolic blood pressure decrease with age in patients with Parkinson's disease?

“…One option is that the anti-Parkinson treatment decreases BP. 3 This is unlikely since Shindo et al 1 analyzed their data in those who received and those who did not receive anti-parkinsonian treatment and found similar results. Another option is that part of BP increase with aging is weight related.…”

“…The patients included in the study by Shindo K. et al had long-standing disease and most had various symptoms of autonomic failure. 1 Indeed, only seven out of 28 patients had orthostatic hypotension. However, it is possible that many patients who had autonomic failure experienced an intermediate postural BP drop below the orthostatic range.…”

“…However, it is possible that many patients who had autonomic failure experienced an intermediate postural BP drop below the orthostatic range. If this was the case, then the study by Shindo 1 is a reflection of the autonomic failure. The best way to identify autonomic failure is by a 24‐h ambulatory BP monitoring (24H ABPM) 6 .…”

“…Hypertension is one of the major modifiable risk factors for cardiovascular (CV) morbidity and mortality. Shindo et al 1 showed in this issue that in patients with Parkinson disease (PD), systolic blood pressure (BP) decreases with age. In the general population, systolic BP rises continuously throughout life, in contrast to diastolic BP which rises until approximately 50 years old, tends to level off over the next decade, and may remain the same or fall later in life 2 .…”

“…It is well known that patients with PD have autonomic failure and experience high rate of orthostatic hypotension. The patients included in the study by Shindo K. et al had long‐standing disease and most had various symptoms of autonomic failure 1 . Indeed, only seven out of 28 patients had orthostatic hypotension.…”