The differences of orthostatic hypotension in patients with Parkinson's disease and multiple system atrophy
BackgroundMultiple system atrophy (MSA) and Parkinson's disease (PD) have similar clinical presentations in their early stages. Orthostatic hypotension (OH) is a common autonomic dysfunction associated with MSA and PD. Heart rate (HR) and systolic blood pressure (SBP) changes are measured in re...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1070943/full |
| _version_ | 1797942749844996096 |
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| author | Jingrong Zeng Yingqi Xing Shanshan Mei Baolei Xu Xiaofan Xue Haixia Song Erhe Xu |
| author_facet | Jingrong Zeng Yingqi Xing Shanshan Mei Baolei Xu Xiaofan Xue Haixia Song Erhe Xu |
| author_sort | Jingrong Zeng |
| collection | DOAJ |
| description | BackgroundMultiple system atrophy (MSA) and Parkinson's disease (PD) have similar clinical presentations in their early stages. Orthostatic hypotension (OH) is a common autonomic dysfunction associated with MSA and PD. Heart rate (HR) and systolic blood pressure (SBP) changes are measured in response to the active standing test, which is widely used to screen for cardiovascular autonomic function.Objectives and methodsOverall, 255 patients (67 MSA, 188 PD) underwent continuous beat-to-beat non-invasive BP monitoring and active standing test. The total standing time was 10 min, and the BP differences between both groups were compared to determine whether the ΔHR/ΔSBP can differentiate both conditions.ResultsClassical orthostatic hypotension (COH) (52%) and initial OH (19%) were most common in MSA and PD, respectively. MSA had a higher HR (75.0 ± 9.7 vs. 71.0 ± 10.7, P = 0.008) than PD in the supine position. SBP (135.70 ± 15.68 mmHg vs. 127.31 ± 15.14 mmHg, P = 0.106), diastolic BP (78.45 ± 12.36 mmHg vs. 67.15 ± 13.39 mmHg, P = 0.009) and HR (73.94 ± 8.39 bpm vs. 71.08 ± 13.52 bpm, P = 0.389) at baseline were higher in MSA-COH than in PD-COH. After adjusting for age and disease duration, the ΔHR/ΔSBP-10 min significantly discriminated MSA-COH from PD-COH (P = 0.031). An ΔHR/ΔSBP-10 min of 0.517 showed a sensitivity of 67% and specificity of 84% (AUC = 0.77, 95% CI: 0.63–0.91).ConclusionThe SBP, diastolic BP, and HR were higher in the supine position; however, ΔHR and ΔSBP were lower after standing in MSA patients than in PD patients. The ΔHR/ΔSBP-10 min discriminated between MSA-COH and PD-COH with quiet acceptable accuracy. |
| first_indexed | 2024-04-10T20:13:13Z |
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| id | doaj.art-217ae8eb918c45ff9e3b3dfc798f1da3 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T20:13:13Z |
| publishDate | 2023-01-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-217ae8eb918c45ff9e3b3dfc798f1da32023-01-26T07:54:26ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-01-011410.3389/fneur.2023.10709431070943The differences of orthostatic hypotension in patients with Parkinson's disease and multiple system atrophyJingrong Zeng0Yingqi Xing1Shanshan Mei2Baolei Xu3Xiaofan Xue4Haixia Song5Erhe Xu6Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, The People's Hospital of Shijiazhuang, Shijiazhuang, Hebei, ChinaDepartment of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, ChinaBackgroundMultiple system atrophy (MSA) and Parkinson's disease (PD) have similar clinical presentations in their early stages. Orthostatic hypotension (OH) is a common autonomic dysfunction associated with MSA and PD. Heart rate (HR) and systolic blood pressure (SBP) changes are measured in response to the active standing test, which is widely used to screen for cardiovascular autonomic function.Objectives and methodsOverall, 255 patients (67 MSA, 188 PD) underwent continuous beat-to-beat non-invasive BP monitoring and active standing test. The total standing time was 10 min, and the BP differences between both groups were compared to determine whether the ΔHR/ΔSBP can differentiate both conditions.ResultsClassical orthostatic hypotension (COH) (52%) and initial OH (19%) were most common in MSA and PD, respectively. MSA had a higher HR (75.0 ± 9.7 vs. 71.0 ± 10.7, P = 0.008) than PD in the supine position. SBP (135.70 ± 15.68 mmHg vs. 127.31 ± 15.14 mmHg, P = 0.106), diastolic BP (78.45 ± 12.36 mmHg vs. 67.15 ± 13.39 mmHg, P = 0.009) and HR (73.94 ± 8.39 bpm vs. 71.08 ± 13.52 bpm, P = 0.389) at baseline were higher in MSA-COH than in PD-COH. After adjusting for age and disease duration, the ΔHR/ΔSBP-10 min significantly discriminated MSA-COH from PD-COH (P = 0.031). An ΔHR/ΔSBP-10 min of 0.517 showed a sensitivity of 67% and specificity of 84% (AUC = 0.77, 95% CI: 0.63–0.91).ConclusionThe SBP, diastolic BP, and HR were higher in the supine position; however, ΔHR and ΔSBP were lower after standing in MSA patients than in PD patients. The ΔHR/ΔSBP-10 min discriminated between MSA-COH and PD-COH with quiet acceptable accuracy.https://www.frontiersin.org/articles/10.3389/fneur.2023.1070943/fullParkinson's diseasemultiple system atrophyorthostatic hypotensionactive standing testthe ΔHR/ΔSBP |
| spellingShingle | Jingrong Zeng Yingqi Xing Shanshan Mei Baolei Xu Xiaofan Xue Haixia Song Erhe Xu The differences of orthostatic hypotension in patients with Parkinson's disease and multiple system atrophy Frontiers in Neurology Parkinson's disease multiple system atrophy orthostatic hypotension active standing test the ΔHR/ΔSBP |
| title | The differences of orthostatic hypotension in patients with Parkinson's disease and multiple system atrophy |
| title_full | The differences of orthostatic hypotension in patients with Parkinson's disease and multiple system atrophy |
| title_fullStr | The differences of orthostatic hypotension in patients with Parkinson's disease and multiple system atrophy |
| title_full_unstemmed | The differences of orthostatic hypotension in patients with Parkinson's disease and multiple system atrophy |
| title_short | The differences of orthostatic hypotension in patients with Parkinson's disease and multiple system atrophy |
| title_sort | differences of orthostatic hypotension in patients with parkinson s disease and multiple system atrophy |
| topic | Parkinson's disease multiple system atrophy orthostatic hypotension active standing test the ΔHR/ΔSBP |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1070943/full |
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