Correlation of HRV and supine hypertension with age of onset and duration of disease in Parkinson's disease
Authors: Parlewar Rupali , Parlewar Rupali , Sharma Ashish , Jani Hitesh , Bhanderi Priti , Verma Punam , Joshi Prabal , Patel Bhoopendra 
Published: May 2023

Background: Natural history and disease progression in patients with Idiopathic Parkinson’s Disease (PD) is quite heterogeneous. Autonomic dysfunction occurs commonly among Idiopathic PD patients. Today, autonomic dysfunctions, including neurogenic orthostatic hypotension (OH), are well‐recognized nonmotor symptoms of patients with PD of all stages. Strong evidence suggests that autonomic dysfunction can actually present as one of the earliest prodromal symptoms occurring years before motor symptoms appear.Most patients with PD describe autonomic symptoms at the time of diagnosis suggesting that these features may have potential sensitivity as clinical biomarkers of the premotor phase. The recognition that damage to peripheral autonomic neurons is present in the early stages of Parkinson disease has led to a search for specific abnormalities in autonomic function that could serve as predictive biomarkers.Hence, Heart rate variability and blood pressure monitoring are used to assess cardiac autonomic dysfunction. The present study aimed to record heart rate variability and supine hypertension in PD patients and to correlate them with the age of onset, duration and severity of the disease, and non‐motor symptom burden. Material and Methods: The sample size is calculated to 50 PD patients in this cross‐sectional study. Disease severity was assessed by Webster rating scale. Non‐motor symptom burden was determined using the Non‐Motor Symptom Scale (NMSS). Ambulatory blood pressure monitoring and heart rate variability were determined. HRV was determined by LF and HF oscillations. Supine hypertension was defined as Systolic Blood Pressure (SBP) ≥150 mmHg and/or DBP ≥90 mmHg. Results: Age of onset was 60.9 ± 7.5 years and duration of disease was 1.5 ± 1.4 years. Mean Webster and non‐motor symptom scores were 12.7 ± 4.4 and 15.5 ± 8.0, respectively. About 41 patients (83%) were normal and no fluctuations, while 9 (17%) had supine hypertension.LF (r = −0.35), HF (r = −0.43), SDNN (−0.40), RMSSD (r = −0.41), NN50 (r = −0.38), PNN50 (r = −0.42), mean SBP (r = 0.26), and mean DBP (r = 0.33) correlated significantly with disease duration. PNN50 (r = −0.255), mean SBP (r = −0.29), and mean DBP (r = −0.27) correlated significantly with age at onset.Low Frequency oscillations (LF) (r = 0.27), High Frequency oscillations (HF) (r = 0.28), Standard Deviation NN intervals (SDNN) (0.26), and Root Mean Squared Successive Differences of NN intervals (RMSSD) (r = 0.27) correlated significantly with non‐motor symptoms scale. Conclusion: Heart rate variability (HRV) parameters are of significant help in the detection of early cardiovascular autonomic dysfunction and correlate significantly with disease duration, age of onset and non‐motor symptom burden among PD patients. Supine hypertension is common in PD patients hence need attention All India Institute of Medical Sciences, Bilaspur H.P 174001 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.