TY - JOUR
T1 - Association of depressive symptoms with circadian blood pressure alterations in Parkinson's disease
AU - Vetrano, Dl
AU - Pisciotta,
AU - Lo Monaco,
AU - Onder, Graziano
AU - Laudisio, A
AU - Brandi, V
AU - La Carpia, D
AU - Guglielmo, M
AU - Nacchia, A
AU - Fusco, D
AU - Ricciardi, D
AU - Bentivoglio, Ar
AU - Bernabei, R
AU - Zuccala', Giuseppe
PY - 2015
Y1 - 2015
N2 - To assess whether among patients with Parkinson's disease (PD) depression, a common non-motor symptom associated with reduced survival, is associated with cardiovascular dysautonomia. We enrolled 125 subjects with PD consecutively admitted to a geriatric day hospital. All participants underwent comprehensive evaluation, fasting blood sampling, and 24-h ambulatory blood pressure monitoring. The percent reduction in nocturnal blood pressure (dipping) was calculated. Depressive symptoms were assessed through the 15-item Geriatric Depression Scale (GDS); a score ≥5 identified moderate to severe symptoms. Among participants (mean age 72.7 ± 7.8 years, 32 % women) 61 subjects (49 %) presented with a GDS score ≥ 5. When compared with other participants, subjects with a GDS score ≥ 5 had reduced adjusted levels of percent systolic (-2.6 ± 2.7 vs. 4.7 ± 2.5; p = 0.003), diastolic (0.6 ± 2.8 vs. 7.4 ± 2.6; p = 0.007), and mean blood pressure dipping (-0.7 ± 2.6 vs. 6.8 ± 2.5; p = 0.002). In separate logistic regression models, depressive symptoms were associated with reduced systolic (OR 0.94; 95 % CI 0.89; 0.98), diastolic (OR 0.94; 95 % CI 0.90; 0.99), and mean blood pressure dipping (OR 0.93; 95 % CI 0.89; 0.98), after adjusting for potential confounders. Depressive symptoms are prevalent, and independently associated with cardiovascular dysautonomia among patients with Parkinson's disease. This might explain the remarkable incidence of sudden death, as well as the association of depressive symptoms with reduced survival reported in these patients. The finding of depressive symptoms in subjects with Parkinson's disease should therefore prompt assessment of cardiovascular autonomic function.
AB - To assess whether among patients with Parkinson's disease (PD) depression, a common non-motor symptom associated with reduced survival, is associated with cardiovascular dysautonomia. We enrolled 125 subjects with PD consecutively admitted to a geriatric day hospital. All participants underwent comprehensive evaluation, fasting blood sampling, and 24-h ambulatory blood pressure monitoring. The percent reduction in nocturnal blood pressure (dipping) was calculated. Depressive symptoms were assessed through the 15-item Geriatric Depression Scale (GDS); a score ≥5 identified moderate to severe symptoms. Among participants (mean age 72.7 ± 7.8 years, 32 % women) 61 subjects (49 %) presented with a GDS score ≥ 5. When compared with other participants, subjects with a GDS score ≥ 5 had reduced adjusted levels of percent systolic (-2.6 ± 2.7 vs. 4.7 ± 2.5; p = 0.003), diastolic (0.6 ± 2.8 vs. 7.4 ± 2.6; p = 0.007), and mean blood pressure dipping (-0.7 ± 2.6 vs. 6.8 ± 2.5; p = 0.002). In separate logistic regression models, depressive symptoms were associated with reduced systolic (OR 0.94; 95 % CI 0.89; 0.98), diastolic (OR 0.94; 95 % CI 0.90; 0.99), and mean blood pressure dipping (OR 0.93; 95 % CI 0.89; 0.98), after adjusting for potential confounders. Depressive symptoms are prevalent, and independently associated with cardiovascular dysautonomia among patients with Parkinson's disease. This might explain the remarkable incidence of sudden death, as well as the association of depressive symptoms with reduced survival reported in these patients. The finding of depressive symptoms in subjects with Parkinson's disease should therefore prompt assessment of cardiovascular autonomic function.
KW - Ambulatory blood pressure monitoring
KW - Depression
KW - Dysautonomia
KW - Non-motor symptoms
KW - Parkinson’s disease
KW - Ambulatory blood pressure monitoring
KW - Depression
KW - Dysautonomia
KW - Non-motor symptoms
KW - Parkinson’s disease
UR - https://publicatt.unicatt.it/handle/10807/70519
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84956742089&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84956742089&origin=inward
U2 - 10.1007/s00415-015-7887-0
DO - 10.1007/s00415-015-7887-0
M3 - Article
SN - 0340-5354
VL - 262
SP - 2564
EP - 2571
JO - Journal of Neurology
JF - Journal of Neurology
IS - 11
ER -