Orthostatic hypotension (OH) is a sustained decrease in blood pressure (BP) after a change in posture, usually when standing upright, caused by a decrease in cardiac output or peripheral vascular resistance. We consider that HO exists when we observe a drop in systolic BP of at least 20 mm Hg or in diastolic BP of at least 10 mg after standing for 3 minutes[i].

HO can cause different symptoms including dizziness, unsteadiness, weakness, tiredness, lightheadedness, headache , feeling of impending fainting and loss of consciousness.

In Parkinson’s disease (PD), alterations of the autonomic system can appear that can cause disorders of the AT[ii]. Different drugs used for the treatment of PD can also be cause of HO (e.g. levodopa, rasagiline, dopaminergic agonists).

In a prospective study of 185 PD patients, HO was found in 65.4% of cases[iii]. These data suggest the need to be active in the detection and treatment of HO in PD patients.

References:

[Freeman R. N Engl J Med 2008; 358: 615-624.

[ii] Goldstein DS. Lancet Neurol 2003; 2: 669-676.

[iii] Hiorth YH et al. Neurology 2019;93: e1526-e1534. doi:10.1212/WNL.0000000000008314