{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T08:21:08Z","timestamp":1781857268285,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T00:00:00Z","timestamp":1643241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>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\u2010h blood pressure (BP) level and variability, and drug treatments for orthostatic hypotension (OH) in MSA patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 129 patients followed at the French Reference Center for MSA who underwent routine 24\u2010h ambulatory BP monitoring were included. Unified MSA Rating Scale (UMSARS) scores, drug treatments and the occurrence and cause of death were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy patients died during follow\u2010up (2.9\u00a0\u00b1\u00a01.8\u00a0years), 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 (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01). In a fully adjusted model, male gender [(female vs. male) hazard ratio (HR) 0.56, 95% CI 0.34\u20130.94, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03], UMSARS I+II score (HR 1.04, 95% CI 1.02\u20131.06, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01), systolic BP daytime variability (HR 3.66, 95% CI 1.46\u20139.17, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and OH treatment (HR: 2.13, 95% CI 1.15\u20133.94, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02) predicted mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15232","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T11:15:06Z","timestamp":1640949306000},"page":"1025-1034","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Ambulatory blood pressure and drug treatment for orthostatic hypotension as predictors of mortality in patients with multiple system atrophy"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-1553","authenticated-orcid":false,"given":"Anne","family":"Pavy\u2010Le Traon","sequence":"first","affiliation":[{"name":"Neurology Department University Hospital of Toulouse and INSERM UMR 1297 French Reference Center for Multiple System Atrophy Institute of Cardiovascular and Metabolic Diseases (I2MC)  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Foubert\u2010Samier","sequence":"additional","affiliation":[{"name":"CRMR AMS Service de Neurologie \u2013 Maladies Neurod\u00e9g\u00e9n\u00e9ratives CHU de Bordeaux  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6179-4500","authenticated-orcid":false,"given":"Fabienne","family":"Ory\u2010Magne","sequence":"additional","affiliation":[{"name":"Neurology Department University Hospital of Toulouse Clinical Investigation Center CIC 1436 Parkinson Expert Centre French Reference Center for Multiple System Atrophy NeuroToul Center of Excellence in Neurodegeneration (COEN) of Toulouse CHU of Toulouse, INSERM University of Toulouse 3  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Neurology Department University Hospital of Toulouse Clinical Investigation Center CIC 1436 Parkinson Expert Centre French Reference Center for Multiple System Atrophy NeuroToul Center of Excellence in Neurodegeneration (COEN) of Toulouse CHU of Toulouse, INSERM University of Toulouse 3  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Michel","family":"Senard","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology Institute of Cardiovascular and Metabolic Diseases (I2MC) Toulouse University Hospital and INSERM UMR 1297  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wassilios G.","family":"Meissner","sequence":"additional","affiliation":[{"name":"CRMR AMS Service de Neurologie \u2013 Maladies Neurod\u00e9g\u00e9n\u00e9ratives CHU de Bordeaux  Bordeaux France"},{"name":"CNRS, IMN, UMR 5293 Univ. 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