{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T03:14:57Z","timestamp":1774322097370,"version":"3.50.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Orthostatic hypotension (OH) in Parkinson\u2019s disease (PD) can lead to falls, impair quality of life, and increase mortality. A trajectory analysis of OH could be useful to predict and prevent the hypotension incidence early.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> The longitudinal data of 660 patients with PD with disease duration up to 12 years were extracted from an integrated PD database. We used latent class mixed modeling (LCMM) to identify patient subgroups, demonstrating trajectories of changes in orthostatic blood pressure (BP) over time. The optimal number of subgroups was selected by several criteria including the Bayesian Information Criterion. Baseline information comparison between groups and backward stepwise logistic regression were conducted to define the distinguishing characteristics of these subgroups and to investigate the predictors for BP trajectory.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> We identified three trajectories for each orthostatic change of systolic blood pressure (\u0394SBP), namely, Class 1 (i.e., the increasing class) consisted of 18 participants with low \u0394SBP that increased continuously during the follow-up; Class 2 (i.e., the low-stable class) consisted of 610 participants with low \u0394SBP that remained low throughout the follow-up; and Class 3 (i.e., the high-stable class) consisted of 32 participants with high \u0394SBP at baseline that was relatively stable throughout the follow-up. Several parameters differed among subgroups, but only male sex [odds ratio (OR) = 4.687, 95% confidence interval (CI) = 1.024\u201321.459], lower supine diastolic blood pressure (DBP) (OR = 0.934, 95% CI = 0.876\u20130.996), and lower level of total protein at baseline (OR = 0.812, 95% CI = 0.700\u20130.941) were significant predictors of an increasing \u0394SBP trajectory.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> This study provides new information on the longitudinal development of \u0394SBP in patients with PD with distinct trajectories of rapidly increasing, low-stable, and high-stable class. The parameters such as male sex, lower supine DBP, and lower total proteins help to identify the rapidly increasing class.<\/jats:p>","DOI":"10.3389\/fnagi.2021.762759","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T05:58:51Z","timestamp":1639979931000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Trajectory Analysis of Orthostatic Hypotension in Parkinson\u2019s Disease: Results From Parkinson\u2019s Progression Markers Initiative Cohort"],"prefix":"10.3389","volume":"13","author":[{"given":"Kui","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kangshuai","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yichen","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongzhe","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanxin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.14802\/jmd.11005","article-title":"Orthostatic hypotension in drug-na\u00efve patients with Parkinson\u2019s disease.","volume":"4","author":"Bae","year":"2011","journal-title":"J. Mov. Disord."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2703","DOI":"10.1002\/mds.28768","article-title":"Orthostatic hypotension in parkinson\u2019s disease: do height and weight matter?","volume":"36","author":"Campese","year":"2021","journal-title":"Mov. Disord."},{"key":"B3","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1097\/MAJ.0b013e318208752b","article-title":"Gender differences in orthostatic hypotension.","volume":"342","author":"Cheng","year":"2011","journal-title":"Am. J. Med. Sci."},{"key":"B4","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1097\/hjh.0b013e3283279860","article-title":"Orthostatic hypotension in genetically related hypertensive and normotensive individuals.","volume":"27","author":"Fedorowski","year":"2009","journal-title":"J. Hypertens."},{"key":"B5","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/s10286-017-0409-7","article-title":"Do we need to evaluate diastolic blood pressure in patients with suspected orthostatic hypotension?","volume":"27","author":"Fedorowski","year":"2017","journal-title":"Clin. Auton. Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1097\/HJH.0b013e328365cd59","article-title":"Systolic and diastolic component of orthostatic hypotension and cardiovascular events in hypertensive patients: the Captopril prevention project.","volume":"32","author":"Fedorowski","year":"2014","journal-title":"J. Hypertens."},{"key":"B7","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s10286-011-0119-5","article-title":"Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome.","volume":"21","author":"Freeman","year":"2011","journal-title":"Clin. Auton. Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement Disorder Society-sponsored revision of the Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results.","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov. Disord."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e1526","DOI":"10.1212\/wnl.0000000000008314","article-title":"Orthostatic hypotension in Parkinson disease: a 7-year prospective population-based study.","volume":"93","author":"Hiorth","year":"2019","journal-title":"Neurology"},{"key":"B10","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1212\/wnl.17.5.427","article-title":"Parkinsonism: onset, progression and mortality.","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"805","DOI":"10.3233\/jpd-160853","article-title":"Prevalence and prescribed treatments of orthostatic hypotension in institutionalized patients with parkinson\u2019s disease.","volume":"6","author":"Hommel","year":"2016","journal-title":"J. Parkinsons Dis."},{"key":"B12","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1016\/j.parkreldis.2014.12.016","article-title":"Severity of orthostatic hypotension in the course of Parkinson\u2019s disease: no correlation with the duration of the disease.","volume":"21","author":"Jost","year":"2015","journal-title":"Parkinsonism Relat. Disord."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2021.111261","article-title":"Improvement of nutritional status enhances cognitive and physical functions in older adults with orthostatic hypotension.","volume":"90","author":"Kocyigit","year":"2021","journal-title":"Nutrition"},{"key":"B14","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1007\/s12603-018-1032-6","article-title":"Malnutrition and malnutrition risk can be associated with systolic orthostatic hypotension in older adults.","volume":"22","author":"Kocyigit","year":"2018","journal-title":"J. Nutr. Health Aging"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1097\/HJH.0b013e328352b9fd","article-title":"Diastolic blood pressure drop after standing as a clinical sign for increased mortality in older falls clinic patients.","volume":"30","author":"Lagro","year":"2012","journal-title":"J. Hypertens."},{"key":"B16","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1111\/j.1468-1331.2006.01512.x","article-title":"EFNS guidelines on the diagnosis and management of orthostatic hypotension.","volume":"13","author":"Lahrmann","year":"2006","journal-title":"Eur. J. Neurol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1080\/01616412.2019.1610224","article-title":"Parkinson\u2019s disease with orthostatic hypotension: analyses of clinical characteristics and influencing factors.","volume":"41","author":"Li","year":"2019","journal-title":"Neurol. Res."},{"key":"B18","doi-asserted-by":"crossref","first-page":"11","DOI":"10.20982\/tqmp.05.1.p011","article-title":"Latent class growth modelling: a tutorial.","volume":"5","author":"Louvet","year":"2009","journal-title":"Tutor. Quant. Methods Psychol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"H734","DOI":"10.1152\/ajpheart.00702.2018","article-title":"Muscle sympathetic nerve activity and hemodynamic responses to venous distension: does sex play a role?","volume":"316","author":"Mansur","year":"2019","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2290","DOI":"10.1161\/01.cir.98.21.2290","article-title":"Orthostatic hypotension predicts mortality in elderly men: the Honolulu Heart Program.","volume":"98","author":"Masaki","year":"1998","journal-title":"Circulation"},{"key":"B21","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1093\/ageing\/afw227","article-title":"A prospective study of the association between orthostatic hypotension and falls: definition matters.","volume":"46","author":"McDonald","year":"2017","journal-title":"Age Ageing"},{"key":"B22","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.parkreldis.2016.09.013","article-title":"Orthostatic hypotension in Parkinson\u2019s disease: does it matter if asymptomatic?","volume":"33","author":"Merola","year":"2016","journal-title":"Parkinsonism Relat. Disord."},{"key":"B23","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1002\/mds.27268","article-title":"Autonomic dysfunction in Parkinson\u2019s disease: a prospective cohort study.","volume":"33","author":"Merola","year":"2018","journal-title":"Mov. Disord."},{"key":"B24","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1146\/annurev.clinpsy.121208.131413","article-title":"Group-based trajectory modeling in clinical research.","volume":"6","author":"Nagin","year":"2010","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.jns.2016.11.027","article-title":"Lower body mass index is associated with orthostatic hypotension in Parkinson\u2019s disease.","volume":"372","author":"Nakamura","year":"2017","journal-title":"J. Neurol. Sci."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ensci.2020.100261","article-title":"Olfactory function deteriorates in patients with Parkinson\u2019s disease complicated with REM sleep behavior disorder.","volume":"20","author":"Nomura","year":"2020","journal-title":"eNeurologicalSci"},{"key":"B27","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1016\/s1471-1931(00)00031-8","article-title":"Levodopa motor complications in Parkinson\u2019s disease.","volume":"23","author":"Obeso","year":"2000","journal-title":"Trends Neurosci."},{"key":"B28","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.parkreldis.2012.01.012","article-title":"Factors related to orthostatic hypotension in Parkinson\u2019s disease.","volume":"18","author":"Perez-Lloret","year":"2012","journal-title":"Parkinsonism Relat. Disord."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1136\/jnnp-2019-320846","article-title":"Orthostatic hypotension and REM sleep behaviour disorder: impact on clinical outcomes in \u03b1-synucleinopathies.","volume":"90","author":"Pilotto","year":"2019","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"B30","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1007\/s10286-019-00652-6","article-title":"Prevalence and factors related to orthostatic syndromes in recently diagnosed, drug-na\u00efve patients with Parkinson disease.","volume":"30","author":"Quarracino","year":"2020","journal-title":"Clin. Auton. Res."},{"key":"B31","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1161\/01.hyp.31.1.435","article-title":"Testosterone exacerbates hypertension and reduces pressure-natriuresis in male spontaneously hypertensive rats.","volume":"31","author":"Reckelhoff","year":"1998","journal-title":"Hypertension"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135933","article-title":"The association between parameters of malnutrition and diagnostic measures of sarcopenia in geriatric outpatients.","volume":"10","author":"Reijnierse","year":"2015","journal-title":"PLoS One"},{"key":"B33","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s00415-018-9104-4","article-title":"Cardiovascular autonomic neuropathy and falls in Parkinson disease: a prospective cohort study.","volume":"266","author":"Romagnolo","year":"2019","journal-title":"J. Neurol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1556\/2060.106.2019.16","article-title":"Sex differences in cardiovascular responses to orthostatic challenge in healthy older persons: a pilot study.","volume":"106","author":"Sachse","year":"2019","journal-title":"Physiol. Int."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1469-7793.1999.0001o.x","article-title":"Pathophysiological basis of orthostatic hypotension in autonomic failure.","volume":"519","author":"Smit","year":"1999","journal-title":"J. Physiol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1002\/mds.25383","article-title":"How to identify tremor dominant and postural instability\/gait difficulty groups with the movement disorder society unified Parkinson\u2019s disease rating scale: comparison with the unified Parkinson\u2019s disease rating scale.","volume":"28","author":"Stebbins","year":"2013","journal-title":"Mov. Disord."},{"key":"B37","doi-asserted-by":"publisher","first-page":"2649","DOI":"10.1002\/mds.23429","article-title":"Systematic review of levodopa dose equivalency reporting in Parkinson\u2019s disease.","volume":"25","author":"Tomlinson","year":"2010","journal-title":"Mov. Disord."},{"key":"B38","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1002\/mdc3.12415","article-title":"Orthostatic hypotension in parkinson\u2019s disease: the relation of blood pressure tests and symptoms in daily life.","volume":"4","author":"Velseboer","year":"2017","journal-title":"Mov. Disord. Clin. Pract."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1111\/j.1468-1331.2007.01982.x","article-title":"Autonomic dysfunction in 3414 parkinson\u2019s disease patients enrolled in the German network on parkinson\u2019s disease (KNP e.V.): the effect of ageing.","volume":"14","author":"W\u00fcllner","year":"2007","journal-title":"Eur. J. Neurol."},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.533731","article-title":"Prevalence and risk factors for malnutrition in patients with parkinson\u2019s disease.","volume":"11","author":"Yang","year":"2020","journal-title":"Front. Neurol."}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2021.762759\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T05:58:54Z","timestamp":1639979934000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2021.762759\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,20]]},"references-count":40,"alternative-id":["10.3389\/fnagi.2021.762759"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2021.762759","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,20]]},"article-number":"762759"}}