Ambulatory 24-hour blood pressure recordings in patients with Parkinson's disease with or without fludrocortisone.
Orthostatic hypotension is often associated with patients suffering from Parkinson's disease. Only few studies have been published about the ambulatory blood pressure in patients with Parkinson's disease. Fludrocortisone has been used in management of orthostatic hypotension. This study was made to determine the Circadian rhythm of blood pressure in healthy elderly people, in Parkinson's disease patients without orthostatic hypotension and Parkinson's disease patients with fludrocortisone medication for orthostatic hypotension. Ambulatory 24-hour blood pressure recordings were made in 20 elderly Parkinson's disease patients and 21 healthy elderly persons. Eight of the Parkinson's disease patients were on fludrocortisone (Florinef) therapy because of orthostatic hypotension. The mean daytime systolic blood pressure of Parkinson's disease patients without fludrocortisone was 123 mmHg and the mean nighttime systolic blood pressure was 121 mmHg. There was no significant difference between daytime and nighttime systolic blood pressure (Figure 1). Diastolic blood pressure in this group was significantly higher during the day (68 mmHg) than at night (63 mmHg) (Figure 2). The daytime blood pressure of control patients was 135/74 mmHg and at night 127/69 mmHg (Figures 1, 2). The blood pressure of Parkinson's disease patients with fludrocortisone was higher at night (156/83 mmHg) than during the day (134/77 mmHg) (Figures 1, 2). The daytime and nighttime systolic and diastolic blood pressure was significantly lower by non-fludrocortisone Parkinson patients than the blood pressure of fludrocortisone Parkinson patients (Figures 1, 2).


CONCLUSIONS
The Parkinson's disease patients were non-dippers and with fludrocortisone the blood pressure was higher at night than on day. On day, the blood pressure of the Parkinson's disease patients with fludrocortisone elevated to the level of controls.
Department of Medicine, Turku City Hospital, Turku, Finland.
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Hakamäki
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Rajala
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Lehtonen
D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D002940:Circadian Rhythm; D005438:Fludrocortisone / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D012016:Reference Values
D000893:Anti-Inflammatory Agents; D000978:Antiparkinson Agents; D005438:Fludrocortisone