Management of Hypertension and Blood Pressure Dysregulation in Patients with Parkinson’s Disease—a Systematic Review

Katsi, Vasiliki; Papakonstantinou, Ilias; Solomou, E; Antonopoulos, Alexios S; Vlachopoulos, Charalambos; Tsioufis, Κonstantinos

doi:10.1007/s11906-021-01146-5

Cited by 10 publications

(7 citation statements)

References 123 publications

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“…One of the possible mechanisms is related with autonomic failure and blood pressure. PD patients often present autonomic failure with blood pressure dysregulation including orthostatic hypotension and supine hypertension, particularly in the late stage of PD [26,27]. This blood pressure dysregulation can lead to cerebral ischemia and subsequent ischemic stroke events.…”

Section: Discussionmentioning

confidence: 99%

Genetic predisposition to Parkinson's disease and risk of cardio and cerebrovascular disease: a Mendelian randomization study

Wang

Zhang

Liu

et al. 2022

Parkinsonism & Related Disorders

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Section: Discussionmentioning

confidence: 99%

Genetic predisposition to Parkinson's disease and risk of cardio and cerebrovascular disease: a Mendelian randomization study

Wang

Zhang

Liu

et al. 2022

Parkinsonism & Related Disorders

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“…About 30-40% of PD patients present orthostatic hypotension, defined as a fall in systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg within 3 min when changing position from supine to standing [80]. The exact pathophysiology of cardiovascular involvement in synucleinopathies is complex and not fully understood.…”

Section: Cardiovascular Symptomsmentioning

confidence: 99%

The Impact of SNCA Variations and Its Product Alpha-Synuclein on Non-Motor Features of Parkinson’s Disease

Magistrelli

Contaldi

Comi

2021

Life

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Parkinson’s disease (PD) is a common and progressive neurodegenerative disease, caused by the loss of dopaminergic neurons in the substantia nigra pars compacta in the midbrain, which is clinically characterized by a constellation of motor and non-motor manifestations. The latter include hyposmia, constipation, depression, pain and, in later stages, cognitive decline and dysautonomia. The main pathological features of PD are neuronal loss and consequent accumulation of Lewy bodies (LB) in the surviving neurons. Alpha-synuclein (α-syn) is the main component of LB, and α-syn aggregation and accumulation perpetuate neuronal degeneration. Mutations in the α-syn gene (SNCA) were the first genetic cause of PD to be identified. Generally, patients carrying SNCA mutations present early-onset parkinsonism with severe and early non-motor symptoms, including cognitive decline. Several SNCA polymorphisms were also identified, and some of them showed association with non-motor manifestations. The functional role of these polymorphisms is only partially understood. In this review we explore the contribution of SNCA and its product, α-syn, in predisposing to the non-motor manifestations of PD.

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“…Although these symptoms may often go unnoticed by the patient, they are associated with important and considerable risks. Orthostatic hypotension can be the cause of unexplained falls, and supine or nocturnal hypertension can lead to potentially fatal renal and cerebral vasculopathies [8,9]. Both parasympathetic [10] and sympathetic [11] nervous system dysfunction have been suggested to contribute to these cardiovascular symptoms.…”

Section: Introductionmentioning

confidence: 99%

Short term cardiovascular symptoms improvement after deep brain stimulation in patients with Parkinson's disease: a systematic review

Cucinotta,

Swinnen,

Makovac

et al. 2024

J Neurol

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Background Autonomic dysfunction is common and disabling in Parkinson's disease (PD). The effects of deep brain stimulation (DBS) on the cardiovascular system in PD remain poorly understood. We aimed to assess the effect of DBS on cardiovascular symptoms and objective measures in PD patients. Methods We conducted a systematic literature search in PubMed/MEDLINE. Results 36 out of 472 studies were included, mostly involving DBS of the subthalamic nucleus, and to a lesser extent the globus pallidus pars interna and pedunculopontine nucleus. Seventeen studies evaluated the effect of DBS on patient-reported or clinician-rated cardiovascular symptoms, showing an improvement in the first year after surgery but not with longer-term follow-up. DBS has no clear direct effects on blood pressure during an orthostatic challenge (n = 10 studies). DBS has inconsistent effects on heart rate variability (n = 10 studies). Conclusion Current evidence on the impact of DBS on cardiovascular functions in PD is inconclusive. DBS may offer short-term improvement of cardiovascular symptoms in PD, particularly orthostatic hypotension, which may be attributed to dopaminergic medication reduction after surgery. There is insufficient evidence to draw conclusions on the direct effect of DBS on blood pressure and heart rate variability.

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Management of Hypertension and Blood Pressure Dysregulation in Patients with Parkinson’s Disease—a Systematic Review

Cited by 10 publications

References 123 publications

Genetic predisposition to Parkinson's disease and risk of cardio and cerebrovascular disease: a Mendelian randomization study

Genetic predisposition to Parkinson's disease and risk of cardio and cerebrovascular disease: a Mendelian randomization study

The Impact of SNCA Variations and Its Product Alpha-Synuclein on Non-Motor Features of Parkinson’s Disease

Short term cardiovascular symptoms improvement after deep brain stimulation in patients with Parkinson's disease: a systematic review

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