Association between nocturnal/supine hypertension and restless legs syndrome in patients with Parkinson's disease

Background and objective: Autonomic disturbances and sleep problems are common non-motor symptoms in patients with Parkinson's disease (PD). Orthostatic hypotension, supine hypertension (SH), and nocturnal hypertension (NH) are inter-related in patients with PD. These abnormalities might be associated with restless legs syndrome (RLS), which occurs predominantly at rest or during sleep. Few reports have suggested an association between circadian blood pressure disturbances and RLS in the general population. We evaluated the relationship between neurocardiovascular blood pressure alterations and RLS in patients with early PD. Methods: A total of 225 patients, newly diagnosed with PD, were included in the study. RLS was diagnosed by the International Restless Legs Syndrome Study Group's diagnostic criteria. Orthostatic vital signs and ambulatory 24-h blood pressure were monitored and recorded. Results: Thirty-six (16.0%) participating patients had RLS. SH and NH were more frequent in the PD + RLS group than in the group without RLS. Supine blood pressure, orthostatic decline in blood pressure, night-time blood pressure, and the standard deviation of systolic blood pressure were significantly higher in the PD + RLS group than in the group without RLS. Conclusion: RLS is related to nocturnal/supine hypertension and blood pressure fluctuations, suggesting a neuropathological association between autonomic and sleep dysfunctions in patients with PD. RLS may be a determinant of neurocirculatory abnormalities. Detecting and effectively treating RLS might slow the rate of pressure-related neurocardiovascular damage in dysautonomic patients with PD. (C) 2014 Elsevier B.V. All rights reserved.