Patients with Parkinson disease present high ambulatory blood pressure variability

Patients with Parkinson disease (PD) present blunted nocturnal blood pressure fall and similar ambulatory blood pressure variability (ABPV) measured by standard deviation (SD) and coefficient of variation (CV) compared with healthy subjects. However, these classical indices of ABPV have limited validity in individuals with circadian blood pressure alterations. New indices, such as the average of daytime and night-time standard deviation weighted by the duration of the daytime and night-time intervals (SDdn) and the average real variability (ARV), remove the influence of the daytime and the night-time periods on ABPV. This study assessed ABPV by SDdn and ARV in PD. Twenty-one patients with PD (11 men, 66 +/- 2years, stages 2-3 of modified Hoehn & Yahr) and 21 matched controls without Parkinson disease (9 men, 64 +/- 1years old) underwent blood pressure monitoring for 24h. ABPV was analysed by 24h, daytime and night-time SD and CV, and by the SDdn and ARV. Systolic/diastolic 24-h and night-time SD and CV were similar between the patients with PD and the controls. The patients with PD presented higher daytime systolic/diastolic CV and SD than the controls (104 +/- 09/123 +/- 08 versus 70 +/- 03/99 +/- 05%, P<005; 126 +/- 10/91 +/- 05 versus 86 +/- 04/75 +/- 03mmHg, P<005, respectively) as well as higher systolic/diastolic SDdn (109 +/- 08/82 +/- 05 versus 82 +/- 03/71 +/- 02mmHg, P<005, respectively) and ARV (88 +/- 06/69 +/- 03 versus 72 +/- 02/60 +/- 02mmHg, P<005, respectively). In conclusion, patients with PD have higher ABPV than control subjects as assessed by SDd, CVd, SDdn and AVR.