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Transient Orthostatic Hypotension Common in Parkinson Disease

PD patients with history of orthostatic intolerance had more severe systolic BP decrease

THURSDAY, Sept. 17, 2020 (HealthDay News) — Transient orthostatic hypotension (tOH) is common in Parkinson disease (PD), according to a study published online Sept. 16 in Neurology.

Alessandra Fanciulli, M.D., Ph.D., from the Medical University of Innsbruck in Austria, and colleagues conducted a retrospective study involving 173 patients with PD and 173 age- and gender-matched controls with orthostatic intolerance who underwent cardiovascular autonomic function testing while undergoing blood pressure monitoring. The authors screened participants for transient and classic OH (cOH) and reviewed medical records of PD patients.

The researchers found that tOH occurred in 24 and 21 percent of PD patients and controls, respectively, while cOH occurred in 19 and 0 percent of PD patients and controls, respectively. Of the PD patients, 40 percent had a history of falls; in 29 percent of cases, these falls were due to syncope. A more severe systolic blood pressure (BP) fall and lower diastolic BP rise upon standing, which was most pronounced in the first 30 to 60 seconds, occurred in PD patients with a history of orthostatic intolerance.

“Similar to syncope, history of orthostatic intolerance was associated with a more severe systolic BP fall, lower diastolic BP values, and reduced diastolic BP rise upon standing, most pronounced during the first minute,” the authors write. “This confirms that transient orthostatic BP falls represent an underrecognized, yet disabling, phenomenon in patients with PD.”

Several authors disclosed financial ties to the biopharmaceutical industry.

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