Evidence map›Paper›PMID 38662269›Full record

ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2024

Hypotensive episodes at 24-h ambulatory blood pressure monitoring predict adverse outcomes in Parkinson's disease.

Fabrizio Vallelonga, Matteo Valente, Marta Maria Tangari, Anna Covolo, Valeria Milazzo, Cristina Di Stefano, Gabriele Sobrero, Marta Giudici, Alberto Milan, Franco Veglio and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
3.4field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 2 countries.

Fabrizio Vallelonga *Division of Internal Medicine, Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142, Km 3,95, Candiolo, 10060, Turin, Italy. fabrizio.vallelonga@unito.it.ORCID http://orcid.org/0000-0002-4628-6767
Matteo Valente *Autonomic Unit and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Marta Maria TangariDepartment of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
Anna CovoloDepartment of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
Valeria MilazzoAutonomic Unit and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Cristina Di StefanoAutonomic Unit and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Gabriele SobreroAutonomic Unit and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Marta GiudiciAutonomic Unit and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Alberto MilanDivision of Internal Medicine, Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142, Km 3,95, Candiolo, 10060, Turin, Italy.
Franco VeglioAutonomic Unit and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Leonardo LopianoDepartment of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
Simona Maule *Autonomic Unit and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Alberto Romagnolo *Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
University of Turin · ITCandiolo Cancer Institute · ITDepartment of Medical Sciences · BY

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNeurogenic orthostatic hypotension (nOH) is a frequent nonmotor feature of Parkinson's disease (PD), associated with adverse outcomes. Recently, 24-h ambulatory blood pressure monitoring (ABPM) showed good accuracy in diagnosing nOH. This study aims at evaluating the prognostic role of ABPM-hypotensive episodes in predicting PD disability milestones and mortality and comparing it to the well-defined prognostic role of bedside nOH.

methodsPatients with PD who underwent ABPM from January 2012 to December 2014 were retrospectively enrolled and assessed for the development of falls, fractures, dementia, bed/wheelchair confinement, hospitalization, and mortality, during an up-to-10-year follow-up. Significant ABPM-hypotensive episodes were identified when greater than or equal to two episodes of systolic BP drop ≥ 15 mmHg (compared with the average 24 h) were recorded during the awakening-to-lunch period.

resultsA total of 99 patients (74% male, age 64.0 ± 10.1 years, and PD duration 6.4 ± 4.0 years) were enrolled. At baseline, 38.4% of patients had ABPM-hypotensive episodes and 46.5% had bedside nOH. On Kaplan-Meier analysis, patients with ABPM-hypotensive episodes showed earlier onset of falls (p = 0.001), fractures (p = 0.004), hospitalizations (p = 0.009), bed/wheelchair confinement (p = 0.032), dementia (p = 0.001), and shorter survival (8.0 versus 9.5 years; p = 0.009). At Cox regression analysis (adjusted for age, disease duration, Charlson Comorbidity Index, and Hoehn and Yahr stage) a significant association was confirmed between ABPM-hypotensive episodes and falls [odds ratio (OR) 3.626; p = 0.001), hospitalizations (OR 2.016; p = 0.038), and dementia (OR 2.926; p = 0.008), while bedside nOH was only associated with falls (OR 2.022; p = 0.039) and dementia (OR 1.908; p = 0.048).

conclusionsThe presence of at least two ABPM-hypotensive episodes independently predicted the development of falls, dementia, and hospitalization, showing a stronger prognostic value than the simple bedside assessment.

Indexed as

Blood Pressure Monitoring, AmbulatoryHypotension, OrthostaticParkinson DiseaseAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPredictive Value of TestsPrognosisRetrospective StudiesAdverse outcomesAmbulatory blood pressure monitoringDisability milestonesHypotensive episodesOrthostatic hypotensionParkinson’s disease

Identifiers

PMID38662269
OpenAlexW4395453712

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.