Cardiopressor effects of short-term treatment with cabergoline in L-dopa stable responder parkinsonian patients: relevance of postprandial hypotension.
The hemodynamic and biochemical effects of cabergoline, a new ergoline derivative with selective, potent, and long-lasting dopamine (DA) agonistic properties, were evaluated in 19 parkinsonian patients, all previously identified as stable responders to levodopa plus L-Dopa decarboxylase inhibitor. The purpose of the study was to find markers capable of predicting the development of cardiopressor side effects during DA-agonistic therapy. Blood pressure (BP), heart rate, and plasma catecholamine responses to a standard meal and a tilt table test were evaluated before and during cabergoline therapy. Cabergoline (1.0 mg/day x os) in this open study significantly reduced the BP response to standing exclusively in the subgroup of patients who exhibited marked postprandial hypotension in baseline conditions. The patients subsequently experienced a partial recovery at day 7 of treatment. This finding indicates that postprandial hypotension is an early marker of autonomic failure in patients with Parkinson's disease (PD) and suggests the usefulness of evaluating cardiopressor response to a standard meal before starting new DA-agonist therapy in PD.
Department of Neurology, C. Mondino Foundation, University of Pavia, Italy.
A
A
Cavallini
G
G
Micieli
E
E
Martignoni
F
F
Blandini
R
R
Fariello
G
G
Nappi
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D000077465:Cabergoline; D015259:Dopamine Agents / Q000494:pharmacology* / Q000627:therapeutic use; D004873:Ergolines / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005502:Food; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000503:physiopathology*; D007024:Hypotension, Orthostatic / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors
D015259:Dopamine Agents; D004873:Ergolines; D000077465:Cabergoline