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Levodopa, bromocriptine and selegiline modify cardiovascular responses in Parkinson's disease

Autonomic nervous system (ANS) involvement is frequently found in Parkinson's disease (PD), but its causal relationship to the disease itself and its medication is unclear. We evaluated the effects of PD medications on cardiovascular ANS functions. Heart rate (HR) responses to normal and deep breath... Full description

Journal Title: Journal of neurology 2000, Vol.247 (11), p.868-874
Main Author: HAAPANIEMI, Tarja H
Other Authors: KALLIO, Mika A , KORPELAINEN, Juha T , SUOMINEN, Kalervo , TOLONEN, Uolevi , SOTANIEMI, Kyösti A , MYLLYLÄ, Vilho V
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin: Springer
ID: ISSN: 0340-5354
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title: Levodopa, bromocriptine and selegiline modify cardiovascular responses in Parkinson's disease
format: Article
creator:
  • HAAPANIEMI, Tarja H
  • KALLIO, Mika A
  • KORPELAINEN, Juha T
  • SUOMINEN, Kalervo
  • TOLONEN, Uolevi
  • SOTANIEMI, Kyösti A
  • MYLLYLÄ, Vilho V
subjects:
  • Aged
  • Biological and medical sciences
  • Blood Pressure - drug effects
  • Blood Pressure - physiology
  • Bromocriptine - therapeutic use
  • Cardiovascular System - drug effects
  • Cardiovascular System - physiopathology
  • Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
  • Female
  • Humans
  • Levodopa - therapeutic use
  • Male
  • Medical sciences
  • Middle Aged
  • Neurology
  • Parkinson Disease - drug therapy
  • Parkinson Disease - physiopathology
  • Selegiline - therapeutic use
ispartof: Journal of neurology, 2000, Vol.247 (11), p.868-874
description: Autonomic nervous system (ANS) involvement is frequently found in Parkinson's disease (PD), but its causal relationship to the disease itself and its medication is unclear. We evaluated the effects of PD medications on cardiovascular ANS functions. Heart rate (HR) responses to normal and deep breathing, the Valsalva manoeuvre and tilting, and blood pressure (BP) responses to tilting and isometric work were measured prospectively in 60 untreated PD patients randomised to receive either levodopa (n = 20), bromocriptine (n = 20) or selegiline (n = 20) as their initial treatment. The results were compared with those of 28 healthy controls. The responses were recorded at baseline, after 6 months on medication and following a 6-week washout period. At baseline HR responses to normal breathing, deep breathing and tilting were already lower and the fall in the systolic BP immediately and at 5 min after tilting was more pronounced in the PD patients than in the controls. Six months' levodopa treatment diminished the systolic BP fall after tilting when compared to baseline, whereas bromocriptine and selegiline increased the fall in systolic BP after tilting and selegiline diminished the BP responses to isometric work. The BP responses returned to the baseline values during the washout period. The drugs induced no change in the HR responses. Thus PD itself causes autonomic dysfunction leading to abnormalities in HR and BP regulation and the PD medications seem to modify ANS responses further. Bromocriptine and selegiline, in contrast to levodopa, increase the orthostatic BP fall and suppress the BP response to isometric exercise reflecting mainly impairment of the sympathetic regulation.
language: eng
source:
identifier: ISSN: 0340-5354
fulltext: no_fulltext
issn:
  • 0340-5354
  • 1432-1459
url: Link


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titleLevodopa, bromocriptine and selegiline modify cardiovascular responses in Parkinson's disease
creatorHAAPANIEMI, Tarja H ; KALLIO, Mika A ; KORPELAINEN, Juha T ; SUOMINEN, Kalervo ; TOLONEN, Uolevi ; SOTANIEMI, Kyösti A ; MYLLYLÄ, Vilho V
creatorcontribHAAPANIEMI, Tarja H ; KALLIO, Mika A ; KORPELAINEN, Juha T ; SUOMINEN, Kalervo ; TOLONEN, Uolevi ; SOTANIEMI, Kyösti A ; MYLLYLÄ, Vilho V
descriptionAutonomic nervous system (ANS) involvement is frequently found in Parkinson's disease (PD), but its causal relationship to the disease itself and its medication is unclear. We evaluated the effects of PD medications on cardiovascular ANS functions. Heart rate (HR) responses to normal and deep breathing, the Valsalva manoeuvre and tilting, and blood pressure (BP) responses to tilting and isometric work were measured prospectively in 60 untreated PD patients randomised to receive either levodopa (n = 20), bromocriptine (n = 20) or selegiline (n = 20) as their initial treatment. The results were compared with those of 28 healthy controls. The responses were recorded at baseline, after 6 months on medication and following a 6-week washout period. At baseline HR responses to normal breathing, deep breathing and tilting were already lower and the fall in the systolic BP immediately and at 5 min after tilting was more pronounced in the PD patients than in the controls. Six months' levodopa treatment diminished the systolic BP fall after tilting when compared to baseline, whereas bromocriptine and selegiline increased the fall in systolic BP after tilting and selegiline diminished the BP responses to isometric work. The BP responses returned to the baseline values during the washout period. The drugs induced no change in the HR responses. Thus PD itself causes autonomic dysfunction leading to abnormalities in HR and BP regulation and the PD medications seem to modify ANS responses further. Bromocriptine and selegiline, in contrast to levodopa, increase the orthostatic BP fall and suppress the BP response to isometric exercise reflecting mainly impairment of the sympathetic regulation.
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subjectAged ; Biological and medical sciences ; Blood Pressure - drug effects ; Blood Pressure - physiology ; Bromocriptine - therapeutic use ; Cardiovascular System - drug effects ; Cardiovascular System - physiopathology ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Female ; Humans ; Levodopa - therapeutic use ; Male ; Medical sciences ; Middle Aged ; Neurology ; Parkinson Disease - drug therapy ; Parkinson Disease - physiopathology ; Selegiline - therapeutic use
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descriptionAutonomic nervous system (ANS) involvement is frequently found in Parkinson's disease (PD), but its causal relationship to the disease itself and its medication is unclear. We evaluated the effects of PD medications on cardiovascular ANS functions. Heart rate (HR) responses to normal and deep breathing, the Valsalva manoeuvre and tilting, and blood pressure (BP) responses to tilting and isometric work were measured prospectively in 60 untreated PD patients randomised to receive either levodopa (n = 20), bromocriptine (n = 20) or selegiline (n = 20) as their initial treatment. The results were compared with those of 28 healthy controls. The responses were recorded at baseline, after 6 months on medication and following a 6-week washout period. At baseline HR responses to normal breathing, deep breathing and tilting were already lower and the fall in the systolic BP immediately and at 5 min after tilting was more pronounced in the PD patients than in the controls. Six months' levodopa treatment diminished the systolic BP fall after tilting when compared to baseline, whereas bromocriptine and selegiline increased the fall in systolic BP after tilting and selegiline diminished the BP responses to isometric work. The BP responses returned to the baseline values during the washout period. The drugs induced no change in the HR responses. Thus PD itself causes autonomic dysfunction leading to abnormalities in HR and BP regulation and the PD medications seem to modify ANS responses further. Bromocriptine and selegiline, in contrast to levodopa, increase the orthostatic BP fall and suppress the BP response to isometric exercise reflecting mainly impairment of the sympathetic regulation.
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titleLevodopa, bromocriptine and selegiline modify cardiovascular responses in Parkinson's disease
authorHAAPANIEMI, Tarja H ; KALLIO, Mika A ; KORPELAINEN, Juha T ; SUOMINEN, Kalervo ; TOLONEN, Uolevi ; SOTANIEMI, Kyösti A ; MYLLYLÄ, Vilho V
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abstractAutonomic nervous system (ANS) involvement is frequently found in Parkinson's disease (PD), but its causal relationship to the disease itself and its medication is unclear. We evaluated the effects of PD medications on cardiovascular ANS functions. Heart rate (HR) responses to normal and deep breathing, the Valsalva manoeuvre and tilting, and blood pressure (BP) responses to tilting and isometric work were measured prospectively in 60 untreated PD patients randomised to receive either levodopa (n = 20), bromocriptine (n = 20) or selegiline (n = 20) as their initial treatment. The results were compared with those of 28 healthy controls. The responses were recorded at baseline, after 6 months on medication and following a 6-week washout period. At baseline HR responses to normal breathing, deep breathing and tilting were already lower and the fall in the systolic BP immediately and at 5 min after tilting was more pronounced in the PD patients than in the controls. Six months' levodopa treatment diminished the systolic BP fall after tilting when compared to baseline, whereas bromocriptine and selegiline increased the fall in systolic BP after tilting and selegiline diminished the BP responses to isometric work. The BP responses returned to the baseline values during the washout period. The drugs induced no change in the HR responses. Thus PD itself causes autonomic dysfunction leading to abnormalities in HR and BP regulation and the PD medications seem to modify ANS responses further. Bromocriptine and selegiline, in contrast to levodopa, increase the orthostatic BP fall and suppress the BP response to isometric exercise reflecting mainly impairment of the sympathetic regulation.
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