Kanegusuku Hélcio, Silva-Batista Carla, Peçanha Tiago, Silva-Junior Natan, Queiroz Andreia, Costa Luiz, Mello Marco, Piemonte Maria, Ugrinowitsch Carlos, Forjaz Cláudia
School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Brazil.
School of Physical Education, Federal University of Minas Gerais, Sao Paulo, Brazil.
Clin Physiol Funct Imaging. 2017 Sep;37(5):530-535. doi: 10.1111/cpf.12338. Epub 2016 Jan 12.
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 (SD ) and the average real variability (ARV), remove the influence of the daytime and the night-time periods on ABPV. This study assessed ABPV by SD and ARV in PD. Twenty-one patients with PD (11 men, 66 ± 2 years, stages 2-3 of modified Hoehn & Yahr) and 21 matched controls without Parkinson disease (9 men, 64 ± 1 years old) underwent blood pressure monitoring for 24 h. ABPV was analysed by 24 h, daytime and night-time SD and CV, and by the SD 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 (10·4 ± 0·9/12·3 ± 0·8 versus 7·0 ± 0·3/9·9 ± 0·5%, P<0·05; 12·6 ± 1·0/9·1 ± 0·5 versus 8·6 ± 0·4/7·5 ± 0·3 mmHg, P<0·05, respectively) as well as higher systolic/diastolic SD (10·9 ± 0·8/8·2 ± 0·5 versus 8·2 ± 0·3/7·1 ± 0·2 mmHg, P<0·05, respectively) and ARV (8·8 ± 0·6/6·9 ± 0·3 versus 7·2 ± 0·2/6·0 ± 0·2 mmHg, P<0·05, respectively). In conclusion, patients with PD have higher ABPV than control subjects as assessed by SD , CV , SD and AVR.
与健康受试者相比，帕金森病（PD）患者夜间血压下降不明显，通过标准差（SD）和变异系数（CV）测量的动态血压变异性（ABPV）相似。然而，这些经典的ABPV指标在昼夜血压改变的个体中有效性有限。新的指标，如根据白天和夜间时长加权的白天和夜间标准差平均值（SD ）以及平均实际变异性（ARV），消除了白天和夜间时段对ABPV的影响。本研究通过SD和ARV评估PD患者的ABPV。21例PD患者（11例男性，66±2岁，改良Hoehn & Yahr分期2 - 3期）和21例匹配的无帕金森病对照者（9例男性，64±1岁）接受了24小时血压监测。通过24小时、白天和夜间的SD和CV以及SD和ARV分析ABPV。PD患者与对照组之间的收缩压/舒张压24小时和夜间SD及CV相似。PD患者白天收缩压/舒张压CV和SD高于对照组（分别为10.4±0.9/12.3±0.8与7.0±0.3/9.9±0.5%，P<0.05；12.6±1.0/9.1±0.5与8.6±0.4/7.5±0.3 mmHg，P<0.05），收缩压/舒张压SD（分别为10.9±0.8/8.2±0.5与8.2±0.3/7.1±0.2 mmHg，P<0.05）和ARV（分别为8.8±0.6/6.9±0.3与7.2±0.2/6.0±0.2 mmHg，P<0.05）也更高。总之，通过SD 、CV 、SD和AVR评估，PD患者的ABPV高于对照受试者。
