Effect of Dopamine Agonist Medications on Blood Pressure in Early Parkinson's Disease (P06.084)

Autor: Lily Wang, Anna Molinari, Chandler E. Gill, P. D. Charles, Yanna Song, Fenna T. Phibbs
Rok vydání: 2012
Předmět:
Zdroj: Neurology. 78:P06.084-P06.084
ISSN: 1526-632X
0028-3878
DOI: 10.1212/wnl.78.1_meetingabstracts.p06.084
Popis: Objective: To determine how Parkinson9s medications affect autonomic function (AF) in early stage disease. Background Non-motor symptoms such as orthostatic hypotension (OH) have been increasingly recognized as factors contributing to disability in early PD. Because PD medications can confound the underlying effect of the disease on AF, a medication washout is necessary to determine the effect of medications. We previously found that heart rate (HR) response to standing was diminished in subjects taking dopamine agonists.¹ Design/Methods: 14 subjects with Hoehn & Yahr Stage II idiopathic PD on optimal drug therapy (ODT) are enrolled in an ongoing clinical trial. Blood pressure (BP) and HR are recorded daily in the seated and standing positions during week-long medication washouts occurring every 6 months for a total of 2 years. Subjects were grouped based on medication regimen: Group 1 levodopa only, Group 2 dopamine agonist monotherapy, Group 3 combination therapy. We report here the AF of subjects one year after enrollment. Results: Diastolic BP (DBP) upon standing was 10 mmHg lower on Day 8 in subjects in Group 2. DBP increased 3.40 mmHg in Group 1 and 3.29 mmHg in Group 3 on Day 8. Comparisons were only significant between Groups 2 and 3 (p=0.03). Subjects in Group 3 experienced the smallest change in DBP over the washout. Changes in systolic BP and HR were not significant. Conclusions: AF in subjects taking levodopa or combination therapy improved over the washout as expected. However, we were surprised to find that DBP in Group 2 worsened. This is most likely due to the extended half-life of dopamine agonists or may suggest that dopamine agonists have an irreversible effect on AF. Future research investigating changes in AF over a washout and the effect of deep brain stimulation on AF will provide important information regarding AF in early PD. Supported by: The clinical trial from which this case is presented is supported by Vanderbilt CTSA grant 1 UL1 RR024975 from the National Center for Research Resources, National Institutes of Health, by a research grant from Medtronic, Inc., and by gifts from private donors. Disclosure: Dr. Molinari has nothing to disclose. Dr. Phibbs has nothing to disclose. Dr. Wang has nothing to disclose. Dr. Gill has nothing to disclose. Dr. Song has nothing to disclose. Dr. Charles has received personal compensation for activities with Allergan, Inc., Ipsen, Medtronic, Inc., Merz Pharma, Pfizer Inc, and Teva Neuroscience. Dr. Charles has received research support from Allergan, Inc., Ipsen, Medtronic, Inc., and Merz Pharma.
Databáze: OpenAIRE
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