Individuals with Parkinson disease (PD) are more likely than to have orthostatic hypotension according to a new study published in Neurology. Because both PD and orthostatic hypotension increase risk of falls, these findings suggest that clinicians should monitor people with PD for orthostatic hypotension.
In this study 173 individuals with PD were compared with 173 individuals referred for orthostatic intolerance (symptoms differing with position). Classic orthostatic hypotension (fall in blood pressure within 3 min of standing) was present in 19% of those with PD and none of those without PD. Of the participants with PD, 24% had transient orthostatic hypotension (immediated fall in blood pressure on standing lasting ~1 min) , and 21% had orthostatic intolerance. After adjusting possible factors affecting the risk of a blood pressure drop, it was determined individuals with PD were twice as likely to have orthostatic hypotension compared to those without PD.
Pharmacologic treatment was prescribed to 18 of 39 participants with transient orthostatic hypotension; 9 used alternative methods (eg, increasing water and salt intake, sleeping with their head at an incline, and wearing a wide compression belt). For those using nonpharmacologic treatment, 6 had improvement. Treatments for hypertension were stopped in 6 participants and 3 of these individuals had symptom improvement.
“In many cases, this can result in falls and fainting,” said study author Alessandra Fanciulli, MD, PhD, of the Medical University of Innsbruck in Austria. “If we can monitor people’s blood pressure to detect this condition, we could potentially control these blood pressure drops and prevent some of the falls that can be so damaging for people with PD.”
Stephanie Kazi, BS; Caleb Heiberger, BS; and Divyajot Sandhu, MD
Tzu-Ying Chuang, MD, PhD, and Dhanashri Miskin, MD