Orthostatic hypotension (OH) is a condition in which a sudden drop in blood pressure occurs when a person stands up from a sitting or lying position.

OH is associated with several underlying medical conditions, including kidney disease, diabetes, and heart disease. However, recent studies suggest that there is another disease that is strongly associated with an increased risk of OH. This article will explore this disease and its relationship to OH.

What is Orthostatic Hypotension?

Before we delve into the disease associated with OH, let us first have a brief overview of OH.

When a person stands up, blood is pulled downwards due to gravity, and the heart has to pump harder to ensure sufficient blood flow to the brain and other organs. A series of reflexes help maintain blood pressure by increasing heart rate, contracting blood vessels and increasing the tone of the sympathetic nervous system.

In people with OH, these reflexes do not work appropriately leading to a sudden fall in blood pressure upon standing. This can cause symptoms such as dizziness, lightheadedness, and in some cases even fainting.

The Disease Associated with a 40% Increased Risk of OH

The disease that has been strongly associated with an increased risk of OH is Parkinson’s disease. Parkinson’s disease is a progressive neurological disorder that affects movement.

It is caused by the death of dopamine-producing cells in the brain. Dopamine is a chemical that helps to transmit signals between nerve cells, and its loss leads to the characteristic movement symptoms of Parkinson’s disease.

A recent study conducted in Japan found that people with Parkinson’s disease have a nearly 40% increased risk of developing OH compared to people without Parkinson’s disease.

The study involved over 600 people with Parkinson’s disease and over 1,200 people without the disease. The researchers measured blood pressure and heart rate changes when participants moved from a lying down to standing position.

They found that OH occurred in 50.9% of people with Parkinson’s disease compared to 31.4% of people without Parkinson’s disease.

Why Parkinson’s Disease Increases the Risk of OH?

The exact reasons why Parkinson’s disease increases the risk of OH are not yet fully understood. However, there are several theories.

One of the leading theories is that Parkinson’s disease affects the areas of the brain that regulate blood pressure. Another theory is that the damage to dopamine-producing cells in the brain affects the nervous system’s ability to regulate blood pressure.

Parkinson’s disease also affects the autonomic nervous system, which controls various involuntary functions, including blood pressure, breathing, and digestion. This can lead to dysautonomia, a condition where the autonomic nervous system does not function correctly, leading to a disruption of blood pressure regulation.

Symptoms of OH in Parkinson’s Disease

OH can present differently in people with Parkinson’s disease compared to those without the disease. This is because the motor symptoms of Parkinson’s disease can mask the symptoms of OH.

Symptoms of OH in Parkinson’s disease can include:.

Dizziness
Lightheadedness
Fainting or loss of consciousness
Postural instability
Freezing of gait or reduced walking speed

It is essential to recognize the symptoms of OH in Parkinson’s disease as it can lead to an increased risk of falls, and in some cases, injuries.

Management of OH in Parkinson’s Disease

The management of OH in Parkinson’s disease typically involves a combination of lifestyle changes and medication.

Lifestyle changes can include increasing salt intake and fluid intake, avoiding alcohol and caffeine, and wearing compression stockings to improve blood flow. Medications that can help manage OH include fludrocortisone, which is a mineralocorticoid that helps the body retain salt and water, and midodrine, which is an alpha-1 agonist that constricts blood vessels.

It is crucial to work with a healthcare provider to develop an individualized treatment plan for OH in Parkinson’s disease, as the management will depend on the severity of symptoms and other underlying medical conditions.

Conclusion

OH is a condition that is strongly associated with Parkinson’s disease. The exact reasons for this association are not yet fully understood, but there are several theories.

People with Parkinson’s disease should be aware of the increased risk of OH and work with their healthcare provider to develop an individualized treatment plan. Management of OH typically involves a combination of lifestyle changes and medication.