The absence of orthostatic heart rate increase is associated with cognitive impairment in Parkinson's disease

Orthostatic hypotension (OH) frequently accompanies autonomic dysfunction and is an important risk factor for cognitive impairment in Parkinson's disease (PD). While OH is usually diagnosed based on an orthostatic blood pressure drop, the association between the heart rate response and cognitiv...

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Bibliographic Details
Published in:PloS one 2020-10, Vol.15 (10), p.e0240491-e0240491
Main Authors: Tanaka, Ryota, Yamashiro, Kazuo, Ogawa, Takashi, Oyama, Genko, Nishioka, Kenya, Umemura, Atsushi, Shimo, Yasushi, Hattori, Nobutaka
Format: Article
Language:English
Subjects:
Age
Aged
Antihypertensives
Autonomic nervous system
Beta blockers
Biology and Life Sciences
Blood Pressure
Cardiovascular disease
Cognitive ability
Cognitive disorders
Cognitive Dysfunction - etiology
Cognitive Dysfunction - pathology
Complications and side effects
Confidence intervals
Coronary vessels
Dementia
Dementia disorders
Diagnosis
Education
Female
Health aspects
Health risks
Heart Rate
Hospitals
Humans
Hypertension
Hypotension
Hypotension, Orthostatic - physiopathology
Impairment
Magnetic resonance imaging
Male
Medical diagnosis
Medical prognosis
Medicine and Health Sciences
Middle Aged
Movement disorders
Neurodegenerative diseases
Neurology
Orthostatic hypotension
Parkinson disease
Parkinson Disease - complications
Parkinson's disease
Parkinsons disease
Patients
Pressure drop
Prognosis
Research and Analysis Methods
Retrospective Studies
Risk analysis
Risk Factors
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Description
Summary:Orthostatic hypotension (OH) frequently accompanies autonomic dysfunction and is an important risk factor for cognitive impairment in Parkinson's disease (PD). While OH is usually diagnosed based on an orthostatic blood pressure drop, the association between the heart rate response and cognitive impairment remains unclear. We retrospectively analyzed 143 cases of clinically diagnosed PD to determine the association between the absence of a heart rate response and cognitive impairment in PD with OH. Among the patients with OH, neurogenic OH was diagnosed in cases without a heart rate increase, while all other patients were diagnosed with non-neurogenic OH. Dementia was found in 23 of 143 PD cases (16.1%) in this cohort. The presence of OH was an independent risk factor for dementia in PD in addition to the disease severity, years of education and beta-blockers use. Neurogenic OH was significantly associated with dementia compared to the no OH group (hazard ratio [HR] 7.3, 95% confidence interval [CI] 2.2-24.6, P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0240491