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Association of depressive symptoms with circadian blood pressure alterations in Parkinson’s disease

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Abstract

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.

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Authors and Affiliations

  1. Centro Medicina dell’Invecchiamento, Dipartimento di Geriatria, Ortopedia e Neuroscienze, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy

    Davide L. Vetrano, Maria S. Pisciotta, Maria R. Lo Monaco, Graziano Onder, Vincenzo Brandi, Domenico La Carpia, Mauro Guglielmo, Antonio Nacchia, Domenico Fusco, Diego Ricciardi, Roberto Bernabei & Giuseppe Zuccalà

  2. Department of Geriatrics, Campus Bio-Medico University, Rome, Italy

    Alice Laudisio

  3. Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy

    Anna R. Bentivoglio

Authors
  1. Davide L. Vetrano
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  2. Maria S. Pisciotta
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  3. Maria R. Lo Monaco
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  4. Graziano Onder
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  5. Alice Laudisio
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  6. Vincenzo Brandi
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  7. Domenico La Carpia
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  8. Mauro Guglielmo
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  9. Antonio Nacchia
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  10. Domenico Fusco
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  11. Diego Ricciardi
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  12. Anna R. Bentivoglio
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  13. Roberto Bernabei
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  14. Giuseppe Zuccalà
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Corresponding author

Correspondence to Davide L. Vetrano.

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The present non-interventional study has been carried out in agreement with the 1964 Declaration of Helsinki.

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Vetrano, D.L., Pisciotta, M.S., Lo Monaco, M.R. et al. Association of depressive symptoms with circadian blood pressure alterations in Parkinson’s disease. J Neurol 262, 2564–2571 (2015). https://doi.org/10.1007/s00415-015-7887-0

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  • DOI: https://doi.org/10.1007/s00415-015-7887-0

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