Blood pressure and heart rate responses to orthostatic challenge and Valsalva manoeuvre in mild cognitive impairment with Lewy bodies
dc.contributor.author | Hamilton, CA | |
dc.contributor.author | Frith, J | |
dc.contributor.author | Donaghy, PC | |
dc.contributor.author | Barker, SAH | |
dc.contributor.author | Durcan, R | |
dc.contributor.author | Lawley, S | |
dc.contributor.author | Barnett, N | |
dc.contributor.author | Firbank, M | |
dc.contributor.author | Roberts, G | |
dc.contributor.author | Taylor, J-P | |
dc.contributor.author | Allan, LM | |
dc.contributor.author | O'Brien, J | |
dc.contributor.author | Yarnall, AJ | |
dc.contributor.author | Thomas, AJ | |
dc.date.accessioned | 2022-03-31T14:37:41Z | |
dc.date.issued | 2022-04-02 | |
dc.date.updated | 2022-03-31T13:02:43Z | |
dc.description.abstract | Objectives Orthostatic hypotension is a common feature of normal ageing, and age-related neurodegenerative diseases, in particular the synucleinopathies including dementia with Lewy bodies. Orthostatic hypotension and other abnormal cardiovascular responses may be early markers of Lewy body disease We aimed to assess whether abnormal blood pressure and heart rate responses to orthostatic challenge and Valsalva manoeuvre would be more common in mild cognitive impairment with Lewy bodies (MCI-LB) than MCI due to Alzheimer’s disease (MCI-AD). Methods MCI patients (n = 89) underwent longitudinal clinical assessment with differential classification of probable MCI-LB, possible MCI-LB, or MCI-AD, with objective autonomic function testing at baseline. Blood pressure and heart rate responses to active stand and Valsalva manoeuvre were calculated from beat-to-beat cardiovascular data, with abnormalities defined by current criteria, and age-adjusted group differences estimated with logistic models. Results Orthostatic hypotension and abnormal heart rate response to orthostatic challenge were not more common in probable MCI-LB than MCI-AD. Heart rate abnormalities were likewise not more common in response to Valsalva manoeuvre in probable MCI-LB. An abnormal blood pressure response to Valsalva (delayed return to baseline/absence of overshoot after release of strain) was more common in probable MCI-LB than MCI-AD. In secondary analyses, magnitude of blood pressure drop after active stand and 10-seconds after release of Valsalva strain were moderately correlated with cardiac sympathetic denervation. Conclusions Probable MCI-LB may feature abnormal blood pressure response to Valsalva, but orthostatic hypotension is not a clear distinguishing feature from MCI-AD. | en_GB |
dc.description.sponsorship | Alzheimer’s Research UK | en_GB |
dc.description.sponsorship | National Institute for Health Research (NIHR) | en_GB |
dc.identifier.citation | Published online 2 April 2022 | en_GB |
dc.identifier.doi | 10.1002/gps.5709 | |
dc.identifier.uri | http://hdl.handle.net/10871/129228 | |
dc.identifier | ORCID: 0000-0002-8912-4901 (Allan, Louise) | |
dc.language.iso | en | en_GB |
dc.publisher | Wiley / International College of Geriatric Psychoneuropharmacology | en_GB |
dc.rights | © 2022 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. | |
dc.subject | orthostatic hypotension | en_GB |
dc.subject | dementia with Lewy bodies | en_GB |
dc.subject | Alzheimer’s disease | en_GB |
dc.subject | mild cognitive impairment | en_GB |
dc.title | Blood pressure and heart rate responses to orthostatic challenge and Valsalva manoeuvre in mild cognitive impairment with Lewy bodies | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2022-03-31T14:37:41Z | |
dc.identifier.issn | 1099-1166 | |
dc.description | This is the final version. Available on open access from Wiley via the DOI in this record | en_GB |
dc.description | Data availability: Data supporting this analysis are available from the corresponding author Calum A. Hamilton. | en_GB |
dc.identifier.journal | International Journal of Geriatric Psychiatry | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2022-03-30 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2022-03-30 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2022-03-31T13:02:50Z | |
refterms.versionFCD | AM | |
refterms.dateFOA | 2022-04-13T12:15:37Z | |
refterms.panel | A | en_GB |
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Except where otherwise noted, this item's licence is described as © 2022 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.