Loss of Autonomic Nervous System Control of Blood Pressure in Patients with Parkinson’s Disease
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2016, Vol 16, Issue 9
Abstract
Parkinson’s disease (PD) manifests with motor symptoms of tremor, bradykinesia, muscle rigidity and postural instability. However, various nonmotor symptoms (NMS) have recently been recognized, among which autonomic dysfunction is observed long before the advent of motor symptoms and is aggravated through the course of the disease. Blood pressure (BP) abnormalities also result from autonomic dysfunction which induces orthostatic hypotension (OH), postprandial hypotension (PPH), nocturnal hypertension (NH) and, in particular, great fluctuation of BP over the range of 100 mmHg in a day that is often monitored by 24-hour ambulatory blood pressure monitoring (ABPM). A number of investigations on autonomic dysfunction in PD using 123I-meta-iodobenzylguanidine (MIBG) myocardial scintigraphy, neuropathology and immunohistochemistry indicate the centripetal degeneration of the cardiac sympathetic nerves and other autonomic pathology in other organs. Since PD patients have lost neural control of BP, their BP should depend on humoral factors that cannot respond to changes in and out of the body as promptly as autonomic nerves. This may be one of the reasons for irregularly fluctuating and unpredictable BP. Hypertensive fluctuation is much riskier than OH and PPH for vascular events of cerebrovascular disease, cardiovascular disease and other organopathies. Non-medical and medical treatments such as calcium channel blocking may be effective to stabilize BP in patients.
Authors and Affiliations
Tetsuro Tsukamoto
Keywords
Related Articles
- EP ID EP341141
- DOI 10.9734/BJMMR/2016/26587
- Views 79
- Downloads 0
Challenges in Providing Rehabilitation Services for People with Disabilities in Iran: A Qualitative Study
Introduction: World Health Organization (WHO) recognizes disability as a global public health issue and a development priority, but unfortunately, the evidence shows that people with disabilities (PWD) often have lower l...
Starting the Conversation- A Childhood Obesity Knowledge Project Using an App
Purpose: Starting the Conversation was a pilot project to test an intervention for childhood obesity, a major public health epidemic, using a free smartphone application (app). The primary aim was to assess students’ kno...
Evaluation of the Selected Root-to-Crown Ratio of Crowned Teeth in a Hospital Setting: A Cross-sectional Study
Aims: The root-to-crown (R/C) ratio is envisaged to influence the longevity of crowned teeth. The purpose of this study is to measure the selected R/C ratio of crowned teeth at the Royal Dental Hospital of Melbourne, and...
Splenic Rupture after Infective Endocarditis by Enterococcus faecalis: Case Report
Aims: In patients with infective endocarditis, with risk of embolization, early identification of parenchymal changes may suggest the risk of splenic rupture. Presentation of Case: A 68-year-old male presented with a his...
Abdominal Aortic Hypoplasia, a Rare Cause of Hypertension
Hypoplasia of the abdominal aorta is an exceedingly rare vascular abnormality. Congenital, acquired, infectious and inflammatory etiologies have been described. Hypertension is the most common presenting symptom. Besides...