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Aging and disease    2016, Vol. 7 Issue (1) : 28-35     DOI: 10.14336/AD.2015.0819
Original Article |
Evaluation of Cardiac Autonomic Functions in Older Parkinson’s Disease Patients: a Cross-Sectional Study
Yalcin Ahmet*, Atmis Volkan, Karaarslan Cengiz Ozlem, Cinar Esat, Aras Sevgi, Varli Murat, Atli Teslime
Department of Geriatric Medicine, Ankara University School of Medicine İbn-I Sina Hospital, Samanpazarı, Altındağ, Ankara, Turkey
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In Parkinson’s disease (PD), non-motor symptoms may occur such as autonomic dysfunction. We aimed to evaluate both parasympathetic and sympathetic cardiovascular autonomic dysfunction in older PD cases. 84 PD cases and 58 controls, for a total of 142, participated in the study. Parasympathetic tests were performed using electrocardiography. Sympathetic tests were assessed by blood pressure measurement and 24-hour ambulatory blood pressure measurement. The prevalence of orthostatic hypotension in PD patients was 40.5% in PD patients and 24.1% in the control group (p> 0.05). The prevalence of postprandial hypotension was 47.9% in the PD group and 27.5% in the controls (p <0.05). The prevalence of impairment in heart rate response to deep breathing was 26.2% in the PD group and 6.9% in the control group (p <0.05). The prevalence of postprandial hypotension in PD with orthostatic hypotension was 94% and 16% in PD patients without orthostatic hypotension (p <0.05). The prevalence of impairment in heart rate response to deep breathing was 52.9% in PD patients with orthostatic hypotension and 8% in PD cases without orthostatic hypotension (p<0.05). The prevalence of impairment in heart rate response to postural change was 41% in PD cases with orthostatic hypotension and 12% in PD cases without orthostatic hypotension (p <0.05).Although there are tests for assessing cardiovascular autonomic function that are more reliable, they are more complicated, and evaluation of orthostatic hypotension by blood pressure measurement and cardiac autonomic tests by electrocardiography are recommended since these tests are cheap and easy.

Keywords autonomic functions      cardiovascular      older      Parkinson’s disease     
Corresponding Authors: Yalcin Ahmet   
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These authors equally contribute this work

Issue Date: 01 February 2016
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Yalcin Ahmet
Atmis Volkan
Karaarslan Cengiz Ozlem
Cinar Esat
Aras Sevgi
Varli Murat
Atli Teslime
Cite this article:   
Yalcin Ahmet,Atmis Volkan,Karaarslan Cengiz Ozlem, et al. Evaluation of Cardiac Autonomic Functions in Older Parkinson’s Disease Patients: a Cross-Sectional Study[J]. Aging and disease, 2016, 7(1): 28-35.
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VariablesPD1 group (n=84)Control group (n=58)P value
Age (years) (mean ± SD)73±7.972.6±4.8NS2
Gender (female/male) (%)54.8%/45.2%55.2%/44.8%NS
Hypertension (%)52.3%89.7%NS
Anti-hypertensive medications (%)52.3%86.2%NS
Table 1  Clinical and Demographic Variables of Study Participants
CV1 autonomic testsPD2 group (n=84)Control group (n=58)P value
OH3 (%)40.5%24.1%NS6
SHT4 (%)23.8%22.8%NS
PPH5 (%)47.6%27.5%0.032
Non-dipper status (%)38.1%37.5%NS
Valsalva ratio<1.21 (%)20.9%15.3%NS
E:I ratio<1.15 (%)26.2%6.9%0.04
30:15 ratio≤1.04 (%)23.8%18.9%NS
Table 2  Cardiovascular Autonomic Tests in PD and Control Groups
VariablesPD1 with OH2 (n=34)PD without OH (n=50)P value
Age (years) (mean±SD)71.3±8.874.2±7.1NS5
PD duration (months) (mean±SD)82.7±60.738.5±46<0.01
Gender (female/male) (%)58.8%/41.2%52%/48%NS
Anti-hypertensive medications (%)47.1%56%NS
L-dopa3 (%)82.4%76%NS
DA4 (%)29.4%20%NS
Selegline (%)23.5%32%NS
Amantadine (%)5.9%4%NS
Table 3  Clinical and Demographic Variables of PD Patients with and without OH
CV1 autonomic testsPD2 with OH3 (n=34)PD without OH (n=50)P value
SHT4 (%)35.3%24%NS6
PPH5 (%)94%16%<0.001
Non-dipper status (%)52.9%28%NS
Valsalva ratio<1.21 (%)29.4%16%NS
E:I ratio<1.15 (%)52.9%8%0.02
30:15 ratio<1.04 (%)41%12%0.031
Table 4  Cardiovascular Autonomic Tests of PD Patients with and without OH
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