Tulbă Delia, Tănăsoiu Aida Cristina, Constantinescu Ana-Maria, Blidaru Natalia, Buzea Adrian, Băicuș Cristian, Dumitrescu Laura, Davidescu Eugenia Irene, Popescu Bogdan Ovidiu
Department of Clinical Neurosciences, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Neurology, Colentina Clinical Hospital, 020125 Bucharest, Romania.
J Clin Med. 2025 Mar 25;14(7):2225. doi: 10.3390/jcm14072225.
: Parkinson's disease (PD) and hypertension are often coexistent conditions that interact in entwined ways at various levels. Cardiovascular autonomic dysfunction (CAD), a non-motor feature of PD occurring across all stages, alters blood pressure (BP) regulation. : We conducted a cross-sectional study enrolling patients with PD and primary hypertension, without diabetes mellitus or other causes of secondary CAD, aiming to characterize BP profiles/patterns by ambulatory BP monitoring. We also sought associations between different CAD phenotypes and PD characteristics, disability, and cardiovascular comorbidities. : We included 47 patients with a median age of 71 years, PD duration of 9 years, and Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III score of 40. Diurnal and nocturnal BP values were within the reference range, but BP load was excessive. Almost one-third had neurogenic orthostatic hypotension (OH) and 80% were non-dippers. The overall burden of non-motor symptoms was significant in these phenotypes. Patients with neurogenic OH were more prone to constipation, anxiety, and urinary problems, whereas gustatory dysfunction, loss of libido, and erectile dysfunction were more frequently reported by non-dippers. No significant differences with regard to cognitive decline were identified in subjects with and without neurogenic OH. Neurogenic OH was symptomatic in 78% of the cases, whereas 56% of those with orthostatic symptoms did not have OH at repeated measurements. : Neurogenic OH is an independent predictor of disability in patients with PD and hypertension, after adjusting for PD duration, Hoehn and Yahr stage, levodopa equivalent daily dose (LEDD), and Montreal Cognitive Assessment (MoCA) score.
帕金森病（PD）和高血压常常并存，且在各个层面以相互交织的方式相互作用。心血管自主神经功能障碍（CAD）是PD在所有阶段都会出现的一种非运动特征，会改变血压（BP）调节。：我们进行了一项横断面研究，纳入了患有PD和原发性高血压、无糖尿病或其他继发性CAD病因的患者，旨在通过动态血压监测来描述血压特征/模式。我们还探寻了不同CAD表型与PD特征、残疾及心血管合并症之间的关联。：我们纳入了47例患者，中位年龄71岁，PD病程9年，运动障碍学会赞助修订的统一帕金森病评定量表（MDS-UPDRS）第三部分评分为40分。日间和夜间血压值在参考范围内，但血压负荷过高。近三分之一的患者有神经源性直立性低血压（OH），80%为非勺型血压。这些表型中非运动症状的总体负担较重。神经源性OH患者更容易出现便秘、焦虑和泌尿系统问题，而非勺型血压患者更常报告味觉功能障碍、性欲减退和勃起功能障碍。在有和没有神经源性OH的受试者中，未发现认知功能下降方面的显著差异。78%的神经源性OH病例有症状，而56%有直立性症状的患者在重复测量时没有OH。：在调整了PD病程、Hoehn和Yahr分期、左旋多巴等效日剂量（LEDD）以及蒙特利尔认知评估（MoCA）评分后，神经源性OH是PD和高血压患者残疾的独立预测因素。
