Cardiovascular disorders in Parkinson's disease
Cardiovascular disorders in Parkinson's disease
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Ang arteryal na hypertension o hypertension ay isang kondisyon ng patuloy na systolic at diastolic na presyon ng dugo, kung saan ang mga sukatan ay lumalagpas sa 140/90 mmHg. Ang mataas na presyon ay nagpapakita ng mga hindi komportableng sintomas.
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Cardiovascular disorders in Parkinson's disease: A complex interaction Parkinson's disease (PD), a neurodegenerative disorder that is mainly characterized by motor symptoms such as Rigidity, Bradykinese and resting tremor, not is often associated with a variety of motor symptoms. One of those aspects relevant to cardiovascular disorders, which occur in a significant proportion of patients and the quality of life, and the forecast can significantly affect the. Pathophysiological Bases The key to the understanding of the cardiovascular complications in Parkinson's disease is the Degeneration of autonomic neural structures. In Parkinson's disease is not only the dopaminergic neurons of the Substantia nigra, but also areas of the autonomic nervous system. This leads to a dysfunction of the autonomic nervous system (ANS), which controls the Regulation of heart rate, blood pressure and vascular tone. Especially the Degeneration of neurons in the dorsal nucleus of the Vagus nerve (Nucleus dorsalis nervi vagi) and in the Central autonomic network plays a crucial role. These pathological changes result in a decreased heart rate variability (HRV) and orthostatic hypotension (OH), which occurs in up to 30% -50% of patients with advanced Parkinson's disease. Frequent Cardiovascular Manifestations Among the most common cardiovascular problems in Parkinson's patients: Orthostatic hypotension (OH): A decrease in the systolic blood pressure of at least 20 mmHg or diastolic at least 10 mmHg within 3 minutes after getting Up. This can lead to dizziness, instability, and even loss of consciousness. Changes in heart rate variability (HRV): A low HRV is considered to be a Marker for impaired autonomic Regulation and is associated with an increased risk for cardiovascular events. Arrhythmias: atrial fibrillation and other supraventricular arrhythmias in patients with Parkinson's disease more often than in the General population. Fluctuations in blood pressure: in addition to orthostatic hypotension, it can also lead to paroxysmal hypertension, especially during the night. Diagnostic Approaches Early diagnosis of these disorders is of crucial importance. Among the common methods of investigation: Tilt‑table Test for the objective diagnosis of orthostatic hypotension. 24‑hour blood pressure monitoring (ABPM) for the detection of fluctuations in blood pressure throughout the day and the night. Long‑term ECG for the detection of arrhythmias and heart rate variability analysis. Autonomic function tests the response of the blood pressure and heart rate to respiratory maneuvers and Valsalva investigate maneuvers. Therapeutic Strategies The treatment of cardiovascular disorders in Parkinson's disease requires a multi-modal approach: Non-pharmacological measures: Increased salt and fluid intake, compression stockings, slowly getting Up and raising the head end of the bed. Pharmacological therapy: Fludrocortisone to increase the blood volume, Midodrine as a vasokonstriktives agent and Pyridostigmine for the improvement of Autonomous Transfer. Adaptation of the Parkinson's medication: Sometimes, the dose must be reduced by Levodopa or other dopaminergic drugs, as these can worsen orthostatic hypotension. Treatment of concomitant diseases: control of hypertension, Diabetes and hyperlipidemia for the reduction of cardiovascular risk. Conclusion Cardiovascular diseases in patients with Parkinson's disease is a significant clinical Problem that results from the Degeneration of the autonomic nervous system. Early detection and adequate treatment of these disorders can improve the quality of life of the Affected significantly and the risk of serious lower cardiovascular events. Further research is necessary to clarify the exact pathophysiological mechanisms, and to develop innovative therapeutic approaches.
Ang arteryal na hypertension o hypertension ay isang kondisyon ng patuloy na systolic at diastolic na presyon ng dugo, kung saan ang mga sukatan ay lumalagpas sa 140/90 mmHg. Ang mataas na presyon ay nagpapakita ng mga hindi komportableng sintomas. Cardiovascular disorders in Parkinson's disease. Ang mga modernong gamot sa pag-imprenta ay hinahati sa 10 iba't ibang grupo ayon sa kanilang mekanismo ng pagkilos. Pagkatapos suriin ng doktor ang mga reklamo ng pasyente at ang resulta ng mga pagsusuri, nagrereseta siya ng isa o higit pang gamot, na hindi dapat baguhin nang mag-isa. Ang mga gamot sa puso at daluyan ng dugo ay hindi kabilang sa mga puwedeng irekomenda sa kaibigan. Ang maling desisyon ay maaaring magdulot ng malungkot na kahihinatnan. Lahat ng gamot na pampababa ng presyon ng dugo ay kailangan ng reseta. Sa artikulong ito, tinitingnan natin ang kanilang modernong klasipikasyon base sa mga aktibong sangkap at sa paraan ng epekto nito sa katawan.
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