Paulo Roberto Moss Lopes, Fernando Luiz Westphal Filho, Frederico De Sousa Marinho Mendes Filho, Caio Eduardo Rodrigues Falcão, Vitor Maia Arca, Jacy Bezerra Parmera
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SH, characterized by elevated supine blood pressure, carries significant cardiovascular and cognitive risks, yet its prevalence in α-synucleinopathies remains inadequately defined.</p><p><strong>Objectives: </strong>We aimed to conduct a systematic review and meta-analysis to assess the prevalence of SH in α-synucleinopathies.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Web of Science databases for studies reporting SH prevalence in patients with α-synucleinopathies. A random-effects model estimated prevalence, stratified by disease type, study design, SH definition, OH presence, and disease duration. Sensitivity analyses were applied to explore sources of variability.</p><p><strong>Results: </strong>Nineteen studies involving 4973 patients were included. The overall SH prevalence was 30.4% (95% CI: 26.4-34.7; I<sup>2</sup> = 87.6%). In PD, SH prevalence was 28.3% (95% CI: 24.0-32.9; I<sup>2</sup> = 86.4%), with OH significantly increasing prevalence (33.9% vs. 21.3%, P = 0.0341). In MSA, SH prevalence was 31.1% (95% CI: 25.9-36.9; I<sup>2</sup> = 30.5%), with OH similarly associated with higher SH prevalence (46.5% vs. 19.8%, P = 0.0023). In DLB, the pooled SH prevalence was 48.7% (95% CI: 39.5-58.1; I<sup>2</sup> = 11.9%). For PAF, a single study reported a prevalence of 48.4% (95% CI: 35.7-61.2).</p><p><strong>Conclusion: </strong>SH is highly prevalent across α-synucleinopathies, with variability by disease type and OH presence. Standardizing diagnostic criteria and investigating its clinical implications are essential to enhance management strategies.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence of Supine Hypertension in Alpha-Synucleinopathies: A Systematic Review and Meta-Analysis.\",\"authors\":\"Paulo Roberto Moss Lopes, Fernando Luiz Westphal Filho, Frederico De Sousa Marinho Mendes Filho, Caio Eduardo Rodrigues Falcão, Vitor Maia Arca, Jacy Bezerra Parmera\",\"doi\":\"10.1002/mdc3.70142\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Alpha-synucleinopathies, including Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA), and Pure Autonomic Failure (PAF), are associated with autonomic dysfunctions such as orthostatic hypotension (OH) and supine hypertension (SH). SH, characterized by elevated supine blood pressure, carries significant cardiovascular and cognitive risks, yet its prevalence in α-synucleinopathies remains inadequately defined.</p><p><strong>Objectives: </strong>We aimed to conduct a systematic review and meta-analysis to assess the prevalence of SH in α-synucleinopathies.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Web of Science databases for studies reporting SH prevalence in patients with α-synucleinopathies. A random-effects model estimated prevalence, stratified by disease type, study design, SH definition, OH presence, and disease duration. Sensitivity analyses were applied to explore sources of variability.</p><p><strong>Results: </strong>Nineteen studies involving 4973 patients were included. The overall SH prevalence was 30.4% (95% CI: 26.4-34.7; I<sup>2</sup> = 87.6%). In PD, SH prevalence was 28.3% (95% CI: 24.0-32.9; I<sup>2</sup> = 86.4%), with OH significantly increasing prevalence (33.9% vs. 21.3%, P = 0.0341). In MSA, SH prevalence was 31.1% (95% CI: 25.9-36.9; I<sup>2</sup> = 30.5%), with OH similarly associated with higher SH prevalence (46.5% vs. 19.8%, P = 0.0023). In DLB, the pooled SH prevalence was 48.7% (95% CI: 39.5-58.1; I<sup>2</sup> = 11.9%). For PAF, a single study reported a prevalence of 48.4% (95% CI: 35.7-61.2).</p><p><strong>Conclusion: </strong>SH is highly prevalent across α-synucleinopathies, with variability by disease type and OH presence. 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引用次数: 0
摘要
背景：α -突触核蛋白病，包括帕金森病（PD）、路易体痴呆（DLB）、多系统萎缩（MSA）和纯粹自主神经衰竭（PAF），与自主神经功能障碍相关，如直立性低血压（OH）和仰卧位高血压（SH）。SH以仰卧位血压升高为特征，具有显著的心血管和认知风险，但其在α-突触核蛋白病中的患病率尚不明确。目的：我们旨在进行一项系统回顾和荟萃分析，以评估α-突触核蛋白病中SH的患病率。方法：我们系统地检索PubMed， Embase和Web of Science数据库，以报告α-突触核蛋白病患者中SH患病率的研究。随机效应模型估计患病率，按疾病类型、研究设计、SH定义、OH存在和疾病持续时间分层。敏感性分析用于探索变异的来源。结果：纳入19项研究，4973例患者。SH总患病率为30.4% (95% CI: 26.4-34.7；i2 = 87.6%)。PD中，SH患病率为28.3% (95% CI: 24.0-32.9；I2 = 86.4%)， OH显著增加患病率（33.9% vs. 21.3%, P = 0.0341）。在MSA， SH患病率为31.1% (95% CI: 25.9-36.9；I2 = 30.5%)， OH与较高的SH患病率相似（46.5% vs. 19.8%, P = 0.0023）。在DLB中，SH的总患病率为48.7% (95% CI: 39.5-58.1；i2 = 11.9%)。一项研究报告PAF患病率为48.4% （95% CI: 35.7-61.2）。结论：SH在α-突触核蛋白病中非常普遍，随疾病类型和OH的存在而变化。标准化诊断标准和研究其临床意义对提高管理策略至关重要。
Prevalence of Supine Hypertension in Alpha-Synucleinopathies: A Systematic Review and Meta-Analysis.
Background: Alpha-synucleinopathies, including Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Multiple System Atrophy (MSA), and Pure Autonomic Failure (PAF), are associated with autonomic dysfunctions such as orthostatic hypotension (OH) and supine hypertension (SH). SH, characterized by elevated supine blood pressure, carries significant cardiovascular and cognitive risks, yet its prevalence in α-synucleinopathies remains inadequately defined.
Objectives: We aimed to conduct a systematic review and meta-analysis to assess the prevalence of SH in α-synucleinopathies.
Methods: We systematically searched PubMed, Embase, and Web of Science databases for studies reporting SH prevalence in patients with α-synucleinopathies. A random-effects model estimated prevalence, stratified by disease type, study design, SH definition, OH presence, and disease duration. Sensitivity analyses were applied to explore sources of variability.
Results: Nineteen studies involving 4973 patients were included. The overall SH prevalence was 30.4% (95% CI: 26.4-34.7; I2 = 87.6%). In PD, SH prevalence was 28.3% (95% CI: 24.0-32.9; I2 = 86.4%), with OH significantly increasing prevalence (33.9% vs. 21.3%, P = 0.0341). In MSA, SH prevalence was 31.1% (95% CI: 25.9-36.9; I2 = 30.5%), with OH similarly associated with higher SH prevalence (46.5% vs. 19.8%, P = 0.0023). In DLB, the pooled SH prevalence was 48.7% (95% CI: 39.5-58.1; I2 = 11.9%). For PAF, a single study reported a prevalence of 48.4% (95% CI: 35.7-61.2).
Conclusion: SH is highly prevalent across α-synucleinopathies, with variability by disease type and OH presence. Standardizing diagnostic criteria and investigating its clinical implications are essential to enhance management strategies.
期刊介绍：
Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)
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