Transtelephonic home blood pressure to assess the monoamine oxidase-B inhibitor rasagiline in Parkinson disease

Hypertension. 2008 Sep;52(3):587-93. doi: 10.1161/HYPERTENSIONAHA.108.115873. Epub 2008 Aug 4.

Abstract

Monoamine oxidase inhibitors are associated with dietary tyramine interactions that can induce hypertensive crises. Rasagiline mesylate is a novel irreversible selective monoamine oxidase type B inhibitor for Parkinson disease that may have a low risk of interaction with dietary tyramine because of its selectivity. To study interactions of rasagiline with diets unrestricted in tyramine-containing foods, we incorporated transtelephonic, self-monitoring of the blood pressure (BP) into a randomized, placebo-controlled trial of rasagiline 0.5 and 1.0 mg daily in 414 levodopa-treated Parkinson patients with motor fluctuations. The proportion of patients with a systolic BP increase of >30 mm Hg was the primary BP end point. In 13 968 self-measured readings at baseline, the proportion of systolic BP values that increased by >30 mm Hg after a meal ranged from 9.5% to 12.9% in the 3 treatment groups. In 25 733 BPs obtained postrandomization, the proportion of values with a >30-mm Hg systolic postprandial increase was 15% in the placebo group, 15% in the rasagiline 0.5-mg group, and 11% in the rasagiline 1-mg group after 3 weeks of double-blind therapy and 13%, 14%, and 12%, respectively, after 26 weeks of treatment (P value was not significant for all of the comparisons among treatment groups). A postprandial increase in systolic BP to >180 mm Hg at any time after randomization was seen in 3.3%, 2.6%, and 2.9% of the placebo, 0.5-mg, and 1.0-mg rasagiline groups, respectively. These data demonstrate that rasagiline did not induce postprandial hypertension in patients with Parkinson disease who were on an unrestricted diet.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antihypertensive Agents / administration & dosage
  • Antiparkinson Agents / administration & dosage
  • Blood Pressure / drug effects
  • Blood Pressure Monitoring, Ambulatory / methods*
  • Female
  • Food
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / etiology
  • Indans / administration & dosage*
  • Levodopa / administration & dosage
  • Male
  • Middle Aged
  • Monoamine Oxidase Inhibitors / administration & dosage*
  • Parkinson Disease / complications*
  • Parkinson Disease / drug therapy
  • Postprandial Period
  • Supine Position
  • Telephone
  • Tyramine / adverse effects

Substances

  • Antihypertensive Agents
  • Antiparkinson Agents
  • Indans
  • Monoamine Oxidase Inhibitors
  • rasagiline
  • Levodopa
  • Tyramine