{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:47:08Z","timestamp":1781880428514,"version":"3.54.5"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">It is widely accepted that patients with \u03b1\u2010synucleinopathy show large blood pressure (BP) variability. We aimed to investigate the diagnostic utility of ambulatory BP monitoring in detecting \u03b1\u2010synucleinopathy in patients with orthostasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We prospectively recruited consecutive patients with orthostatic dizziness between December 2021 and February 2024 at the Dizziness Center of a tertiary referral\u2010based hospital in South Korea. All patients underwent a detailed examination using Frenzel goggles and systematic extrapyramidal neurologic examination for eligibility. All patients underwent 24\u2010hour noninvasive ambulatory BP monitoring and head\u2010up tilt table test using a Finometer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among the 223 patients, 22 (10%) were finally diagnosed with \u03b1\u2010synucleinopathy. The diagnosis could have been made with emergence of motor symptoms 1 to 3\u2009years after the presentation in 5 (22%) of the 22 patients. The coefficient of variance of systolic BP (SBP;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.023) and differences in the average systolic BP between day and night (\n                      <jats:italic toggle=\"no\">P=<\/jats:italic>\n                      0.001) were associated with \u03b1\u2010synucleinopathy, after adjusting for other covariates. Differences in the average systolic BP between day and night yielded a sensitivity of 76.2% and specificity of 83.6% in discriminating \u03b1\u2010synucleinopathy, with an area under the curve of 0.79 (95% CI, 0.66\u20130.92). The sensitivity and specificity were 77.3% and 71.6% with an area under the curve of 0.80 (95% CI, 0.70\u20130.90) for the coefficient of variance of systolic BP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Our findings implicate that ambulatory BP monitoring can help detect \u03b1\u2010synucleinopathy in patients with orthostasis. Large BP variability and loss of circadian BP rhythm during ambulatory BP monitoring can serve as early warning signs of \u03b1\u2010synucleinopathy, even before the prominent manifestation of motor symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043276","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T12:29:29Z","timestamp":1760444969000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Blood Pressure Variability as a Diagnostic Marker for \u03b1\u2010Synucleinopathy in Patients With Orthostasis"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2627-6047","authenticated-orcid":false,"given":"Tonghoon","family":"Woo","sequence":"first","affiliation":[{"name":"Korea University Medical Center","place":["Seoul, South 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