Transtelephonic home blood pressure to assess the monoamine oxidase-B inhibitor rasagiline in Parkinson disease.
Monoamine oxidase inhibitors are associated with dietary tyramine interactions that can induce hypertensive crises. Rasagiline mesylate is a novel irreversible selective monoamine oxidase type B inhibitor for Parkinson disease that may have a low risk of interaction with dietary tyramine because of its selectivity. To study interactions of rasagiline with diets unrestricted in tyramine-containing foods, we incorporated transtelephonic, self-monitoring of the blood pressure (BP) into a randomized, placebo-controlled trial of rasagiline 0.5 and 1.0 mg daily in 414 levodopa-treated Parkinson patients with motor fluctuations. The proportion of patients with a systolic BP increase of >30 mm Hg was the primary BP end point. In 13 968 self-measured readings at baseline, the proportion of systolic BP values that increased by >30 mm Hg after a meal ranged from 9.5% to 12.9% in the 3 treatment groups. In 25 733 BPs obtained postrandomization, the proportion of values with a >30-mm Hg systolic postprandial increase was 15% in the placebo group, 15% in the rasagiline 0.5-mg group, and 11% in the rasagiline 1-mg group after 3 weeks of double-blind therapy and 13%, 14%, and 12%, respectively, after 26 weeks of treatment (P value was not significant for all of the comparisons among treatment groups). A postprandial increase in systolic BP to >180 mm Hg at any time after randomization was seen in 3.3%, 2.6%, and 2.9% of the placebo, 0.5-mg, and 1.0-mg rasagiline groups, respectively. These data demonstrate that rasagiline did not induce postprandial hypertension in patients with Parkinson disease who were on an unrestricted diet.
White
William B
WB
Division of Hypertension and Clinical Pharmacology, Pat and Jim Calhoun Cardiology Center and Clinical Trials Unit, University of Connecticut, Farmington, Connecticut 06030-3940, USA. wwhite@nso1.uchc.edu
Salzman
Phyllis
P
Schwid
Steven R
SR
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D000978:Antiparkinson Agents / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D005502:Food; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D007189:Indans / Q000008:administration & dosage*; D007980:Levodopa / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage*; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy; D019518:Postprandial Period; D016683:Supine Position; D013689:Telephone; D014439:Tyramine / Q000009:adverse effects
D000959:Antihypertensive Agents; D000978:Antiparkinson Agents; D007189:Indans; D008996:Monoamine Oxidase Inhibitors; C031967:rasagiline; D007980:Levodopa; D014439:Tyramine