Ambulatory blood pressure and drug treatment for orthostatic hypotension as predictors of mortality in patients with multiple system atrophy.
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| Title: | Ambulatory blood pressure and drug treatment for orthostatic hypotension as predictors of mortality in patients with multiple system atrophy. |
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| Authors: | Pavy‐Le Traon, Anne (AUTHOR), Foubert‐Samier, Alexandra (AUTHOR), Ory‐Magne, Fabienne (AUTHOR), Fabbri, Margherita (AUTHOR), Senard, Jean‐Michel (AUTHOR), Meissner, Wassilios G. (AUTHOR), Rascol, Olivier (AUTHOR), Amar, Jacques (AUTHOR) |
| Source: | European Journal of Neurology. Apr2022, Vol. 29 Issue 4, p1025-1034. 10p. |
| Subjects: | Multiple system atrophy, Orthostatic hypotension, Blood pressure, Sudden death, Dysautonomia, Cerebellar ataxia |
| Abstract: | Objectives: Multiple system atrophy (MSA) is a rare fatal neurodegenerative disease characterized by parkinsonism, cerebellar ataxia and autonomic failure. This study was aimed at investigating possible associations between mortality, 24‐h blood pressure (BP) level and variability, and drug treatments for orthostatic hypotension (OH) in MSA patients. Methods: A total of 129 patients followed at the French Reference Center for MSA who underwent routine 24‐h ambulatory BP monitoring were included. Unified MSA Rating Scale (UMSARS) scores, drug treatments and the occurrence and cause of death were recorded. Results: Seventy patients died during follow‐up (2.9 ± 1.8 years), mainly from terminal illness, pulmonary or sudden death. Multivariate Cox regression analysis, after adjustment for gender, disease duration and severity (UMSARS I+II score), showed that increased daytime systolic BP variability, OH severity and OH drug treatment were independently correlated with mortality. OH treatment was associated with the risk of cardiac causes and/or sudden death (p = 0.01). In a fully adjusted model, male gender [(female vs. male) hazard ratio (HR) 0.56, 95% CI 0.34–0.94, p = 0.03], UMSARS I+II score (HR 1.04, 95% CI 1.02–1.06, p < 0.01), systolic BP daytime variability (HR 3.66, 95% CI 1.46–9.17, p < 0.01) and OH treatment (HR: 2.13, 95% CI 1.15–3.94, p = 0.02) predicted mortality. Conclusions: Increased daytime BP variability and OH treatment were predictive of mortality in patients with MSA, independently from disease severity. Further studies are required to assess if these associations are explained by more severe autonomic dysfunction or if OH treatment exposes per se to a specific risk in this population. [ABSTRACT FROM AUTHOR] |
| Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 155659026 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Ambulatory blood pressure and drug treatment for orthostatic hypotension as predictors of mortality in patients with multiple system atrophy. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Pavy‐Le+Traon%2C+Anne%22">Pavy‐Le Traon, Anne</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Foubert‐Samier%2C+Alexandra%22">Foubert‐Samier, Alexandra</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ory‐Magne%2C+Fabienne%22">Ory‐Magne, Fabienne</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fabbri%2C+Margherita%22">Fabbri, Margherita</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Senard%2C+Jean‐Michel%22">Senard, Jean‐Michel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Meissner%2C+Wassilios+G%2E%22">Meissner, Wassilios G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rascol%2C+Olivier%22">Rascol, Olivier</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Amar%2C+Jacques%22">Amar, Jacques</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Apr2022, Vol. 29 Issue 4, p1025-1034. 10p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Multiple+system+atrophy%22">Multiple system atrophy</searchLink><br /><searchLink fieldCode="DE" term="%22Orthostatic+hypotension%22">Orthostatic hypotension</searchLink><br /><searchLink fieldCode="DE" term="%22Blood+pressure%22">Blood pressure</searchLink><br /><searchLink fieldCode="DE" term="%22Sudden+death%22">Sudden death</searchLink><br /><searchLink fieldCode="DE" term="%22Dysautonomia%22">Dysautonomia</searchLink><br /><searchLink fieldCode="DE" term="%22Cerebellar+ataxia%22">Cerebellar ataxia</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: Multiple system atrophy (MSA) is a rare fatal neurodegenerative disease characterized by parkinsonism, cerebellar ataxia and autonomic failure. This study was aimed at investigating possible associations between mortality, 24‐h blood pressure (BP) level and variability, and drug treatments for orthostatic hypotension (OH) in MSA patients. Methods: A total of 129 patients followed at the French Reference Center for MSA who underwent routine 24‐h ambulatory BP monitoring were included. Unified MSA Rating Scale (UMSARS) scores, drug treatments and the occurrence and cause of death were recorded. Results: Seventy patients died during follow‐up (2.9 ± 1.8 years), mainly from terminal illness, pulmonary or sudden death. Multivariate Cox regression analysis, after adjustment for gender, disease duration and severity (UMSARS I+II score), showed that increased daytime systolic BP variability, OH severity and OH drug treatment were independently correlated with mortality. OH treatment was associated with the risk of cardiac causes and/or sudden death (p = 0.01). In a fully adjusted model, male gender [(female vs. male) hazard ratio (HR) 0.56, 95% CI 0.34–0.94, p = 0.03], UMSARS I+II score (HR 1.04, 95% CI 1.02–1.06, p < 0.01), systolic BP daytime variability (HR 3.66, 95% CI 1.46–9.17, p < 0.01) and OH treatment (HR: 2.13, 95% CI 1.15–3.94, p = 0.02) predicted mortality. Conclusions: Increased daytime BP variability and OH treatment were predictive of mortality in patients with MSA, independently from disease severity. Further studies are required to assess if these associations are explained by more severe autonomic dysfunction or if OH treatment exposes per se to a specific risk in this population. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/ene.15232 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 1025 Subjects: – SubjectFull: Multiple system atrophy Type: general – SubjectFull: Orthostatic hypotension Type: general – SubjectFull: Blood pressure Type: general – SubjectFull: Sudden death Type: general – SubjectFull: Dysautonomia Type: general – SubjectFull: Cerebellar ataxia Type: general Titles: – TitleFull: Ambulatory blood pressure and drug treatment for orthostatic hypotension as predictors of mortality in patients with multiple system atrophy. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Pavy‐Le Traon, Anne – PersonEntity: Name: NameFull: Foubert‐Samier, Alexandra – PersonEntity: Name: NameFull: Ory‐Magne, Fabienne – PersonEntity: Name: NameFull: Fabbri, Margherita – PersonEntity: Name: NameFull: Senard, Jean‐Michel – PersonEntity: Name: NameFull: Meissner, Wassilios G. – PersonEntity: Name: NameFull: Rascol, Olivier – PersonEntity: Name: NameFull: Amar, Jacques IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2022 Type: published Y: 2022 Identifiers: – Type: issn-print Value: 13515101 Numbering: – Type: volume Value: 29 – Type: issue Value: 4 Titles: – TitleFull: European Journal of Neurology Type: main |
| ResultId | 1 |
