The 24-hour oscillation of blood pressure and heart rate in Parkinson's disease: Circadian and sleepeffects

Abnormal circadian rhythms have been reported in extrapyramidal syndromes. This study aimed to evaluate sleep and circadian influences on autonomic pathways controlling blood pressure and heart rate 24-h oscillations in PD. We evaluated 8 patients with PD (6 males, age 58±12 years) and 3 controls (CN:2 males, 58±8 yrs). Systolic and dyastolic blood pressure (SBP, DBP) and heart rate (HR) were continuously monitored for 48 h by a Portapres model II. Sleep-wake cycle was simultaneously monitored with an ambulant polygraphic recorder (Oxford Medilog 9200. Parameters recorded: EEC, EOG, ECG, EMG). The patients during the study lived in a temperature-controlled room, lying in bed except for eating 6 times per day (1800 Kcal) in a fixed light-dark schedule. The sleep stages were scored according to the criteria suggested by Rechtschaffen and Kales, considering epochs of 30 s. Mean SBP, DBP and HR were evaluated during the same 30-s periods. Circadian rhythmicity of SBP, DBP and HR was analyzed on the different 24-h recordings according to the single cosinor method. Mean SBP, DBP and HR during wakefulness and deep, light and REM sleep were evaluated. To date we have analyzed data from 3 PD patients and 3 controls. In these patients the 24-h oscillation of SBP, DBP and HR was preserved and the physiological nocturnal fall of these parameters was present. Mean±SD SBP/DBP during wakefulness was: PD=141±16/78±4, CN=127±8/73±3 mmHg; during phase 1-2: PD=129±14/71±7, CN=118±9/67±3 mmHg; during phase 3-4: PD=127±18/69±9, CN=115±7/64±4 mmHg; during REM: PD=137±19/76±8, CN=124±19/68±6 mmHg. Mean±SD HR during wakefulness was: PD= 60±12, CN=74±13 b/m; during phase 1-2 NREM: PD=50±9, CN=64±12 b/m; during phase 3-4 NREM: PD=50±11, CN=64±12 b/m; during REM: PD=52±10, CN=66±10 b/m. The complete analysis of the data will be presented at the meeting.