Parkinson’s disease: Orthostatic hypotension is a lesser known warning – what is it?

Parkinson’s disease is a chronic, progressive disease that damages the nerves, including those that are responsible for maintaining blood pressure. In addition, dopaminergic drugs that are used to treat Parkinson’s disease may cause or worsen orthostatic hypotension. What is orthostatic hypotension and what are the symptoms to spot?

Parkinson’s is caused by a loss of nerve cells in a specific part of the brain.

These nerve cells are used to help send messages between the brain and the nervous system.

Parkinson’s disease symptoms tend to develop gradually, and only appear as mild at first.

One early warning sign of the condition is orthostatic hypotension relating to one’s blood pressure.

Orthostatic hypotension is a drop in blood pressure upon changing positions, such as moving from sitting to standing, said Dr Rachel Dolhun, a movement disorder specialist.

She continued: “It’s also a non-motor symptom of Parkinson’s disease.

“Orthostatic hypotension may cause light-headedness and dizziness, which can result in passing out, fatigue and nausea.

“It could also contribute to gait instability and falls.”

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In a study published in the US National Library of Medicine National Institutes of Health, neurogenic orthostatic hypotension in Parkinson’s disease was investigated.

The study noted: “Neurogenic orthostatic hypotension is due to failure of the autonomic nervous system to regulate blood pressure in response to postural changes due to an inadequate release of norepinephrine, leading to orthostatic hypotension and supine hypertension.

“Neurogenic orthostatic hypotension is common in Parkinson’s disease

“Prevalence varies throughout the course of Parkinson’s disease, ranging from 40 percent to 60 percent, and resulting in symptomatic neurogenic orthostatic hypotension in approximately half.” 

Symptoms to spot

Symptoms of orthostatic hypotension include light-headedness, weakness, dizziness, difficulty thinking, feeling faint, and headache.

Orthostatic hypotension is generally evaluated by measuring the blood pressure of a patient while sitting, or lying down, and again while standing.

If a person’s blood pressure drops more than 20 mm Hg in systolic pressure (the top number) or more than 10 mm Hg in diastolic pressure (the bottom number) they are considered to have orthostatic hypotension.

Studies suggest a more accurate way to diagnose orthostatic hypotension is using a calculation called “upright mean arterial blood pressure,” which takes into account both the systolic and diastolic blood pressures.

When this number is under 75 mm Hg, it indicates orthostatic hypotension.

Common signs of Parkinson’s disease include tremors, slow movement, and muscle stiffness.

The muscle stiffness makes facial expressions more difficult, said the charity.

Tremors usually start in the hand or the arm and are more likely to occur when the arm is relaxed.

There are about 145,000 people in the UK with Parkinson’s disease, and it’s the fastest growing neurological condition in the world.

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