Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Chronobiol Int. 2013 Jul;30(6):811-7. doi: 10.3109/07420528.2013.766618. Epub 2013 Jun 6.
Increasing evidence indicates that nocturnal blood pressure level and/or loss of nocturnal blood pressure dips are sensitive markers of cardiovascular morbidity and mortality. Several studies have suggested that blunted heart rate variability and nocturnal decline in heart rate are also associated with target organ damage. These phenomena occur relatively commonly in patients with Parkinson disease (PD); however, few studies have assessed the consequences of these abnormalities in patients with PD. We investigated the influence of circadian changes in blood pressure and heart rate on white matter hyperintensities (WMHs) in patients with PD. The presence of nocturnal hypertension was associated with increased WMH score, and nighttime systolic pressure was closely related with white matter changes. Blunted heart rate variability and nocturnal decline in heart rate were also related to increasing WMH scores. The non-dipping phenomenon did not influence WMHs. These findings suggest that white matter changes are related to circadian autonomic dysfunction, particularly nocturnal hypertension in patients with PD. Therefore, it is important to monitor nocturnal blood pressure status, because modifying these circadian regulatory disturbances can be beneficial to protect against vascular brain damage in patients with PD.
越来越多的证据表明，夜间血压水平和/或夜间血压下降幅度的丧失是心血管发病率和死亡率的敏感标志物。多项研究表明，心率变异性降低和夜间心率下降也与靶器官损伤有关。这些现象在帕金森病（PD）患者中较为常见；然而，很少有研究评估 PD 患者这些异常的后果。我们研究了血压和心率昼夜变化对帕金森病患者脑白质高信号（WMHs）的影响。夜间高血压的存在与 WMH 评分增加有关，夜间收缩压与白质变化密切相关。心率变异性降低和夜间心率下降也与 WMH 评分增加有关。非杓型现象对 WMHs 没有影响。这些发现表明，白质变化与昼夜自主神经功能障碍有关，尤其是 PD 患者的夜间高血压。因此，监测夜间血压状态非常重要，因为调节这些昼夜节律紊乱可能有益于保护 PD 患者的血管性脑损伤。
