Blood pressure and heart rate in parkinsonian patients with and without wearing-off

Our study aimed to investigate the cardiovascular autonomic regulation related to the wearing-off phenomenon in Parkinson's disease (PD). We measured blood pressure (BP) and heart rate (HR) at rest and during orthostatic test in 16 patients with PD with wearing-off and in 15 patients with PD without wearing-off both before (baseline) and repetitively at 1-h intervals for up to 4 h after the morning PD medication dose.
The patients with wearing-off had fluctuation of BP during the observation period, BP increasing when the motor performance worsened and vice versa. The mean supine BP was at its highest at the baseline measurement (patients with wearing-off, 145 ± 18 mmHg; patients without wearing-off, 138 ± 17 mmHg), fell during the first hour (patients with wearing-off, 119 ± 17 mmHg; patients without wearing-off, 126 ± 18 mmHg), and then rose again toward the end of the observation period (patients with wearing-off, 136 ± 15 mmHg; patients without wearing-off, 138 ± 18 mmHg). This BP change was statistically significant only in PD patients with wearing-off ( P  < 0.001).
In conclusion, BP seems to fluctuate with motor impairment in PD patients with wearing-off. This fluctuation may represent autonomic dysfunction caused by the PD process itself, the effect of PD medication, or both.