Fernando Chathurini V, Osborn Sarah, Horne Malcolm
Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3010, Australia.
The Bionics Institute, East Melbourne, VIC 3002, Australia.
J Pers Med. 2023 Aug 28;13(9):1324. doi: 10.3390/jpm13091324.
Orthostatic hypotension (OH) is common in Parkinson's Disease (PD). It is intermittent, exacerbated by stressors including meals, medications, and dehydration, and frequently is unrecognized. Although intermittent, assessment is usually by a single "in clinic" BP measurement. This study examines whether 10 home measurements are more sensitive in detecting OH than a single "in clinic" measurement. Participants (44 people with PD and 16 controls) were instructed to measure lying and standing BP at home. BP was measured on five consecutive days upon waking and before bedtime. Symptoms were also assessed using the Movement Disorder Society United Parkinson's Disease Rating Scale and the Non-Motor Questionnaire. While a postural drop in systolic BP (≥20 mmHg) was recorded "in clinic" in thirteen of the forty-four PD participants, a postural drop was found in at least one of the ten home measurements in twenty-eight of the forty-four participants. Morning hypertension and variability in lying systolic BP was more common in these subjects than in those without a postural drop or the controls. A greater number of measurements of lying and standing BP are more likely to reveal orthostatic hypotension, variation in systolic BP, and hypertension than a single office measurement in people with PD.
直立性低血压（OH）在帕金森病（PD）中很常见。它是间歇性的，会因包括进餐、药物和脱水在内的应激因素而加重，且常常未被识别。尽管是间歇性的，但评估通常通过单次“在诊所”的血压测量进行。本研究探讨10次家庭测量在检测OH方面是否比单次“在诊所”测量更敏感。参与者（44名帕金森病患者和16名对照者）被指导在家中测量卧位和立位血压。在醒来时和就寝前连续五天测量血压。还使用运动障碍协会统一帕金森病评定量表和非运动问卷评估症状。在44名帕金森病参与者中，有13人在“诊所”记录到收缩压体位性下降（≥20 mmHg），而在44名参与者中的28人，在10次家庭测量中的至少一次发现了体位性下降。与没有体位性下降的患者或对照者相比，这些受试者中晨间高血压和卧位收缩压变异性更为常见。对于帕金森病患者，与单次诊室测量相比，更多次数的卧位和立位血压测量更有可能揭示直立性低血压、收缩压变异性和高血压。
