A Common Cause Of Dizziness in Patients With Parkinson's Disease - Orthostatic Hypotension

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Orthostatic hypotension is a common cardiovascular dysfunction in patients with Parkinson's disease (PD). It may be present in nearly 60% of PD patients, although only a minority of these patients may be symptomatic. The diagnosis of orthostatic hypotension in PD patients may vary. Not all patients experience the typical symptoms of top-heavy feet or dizziness when standing, but may be described as blurred vision or thinking when standing, "coat-hanger" pain when standing or pain in the lower back or hips, or just standing When drowsy. Sometimes traditional ways of measuring orthostatic hypotension in the hospital may not produce a clear drop in blood pressure and may require other methods such as tilt testing, 24-h ambulatory blood pressure monitoring, or the use of a continuous noninvasive arterial pressure monitor.

When the patient experiences dizziness or drowsiness when changing from supine to upright position, and the situation improves significantly after lying down, it is necessary to consider whether there is orthostatic hypotension. Simple measurement of orthostatic hypotension only requires a sphygmomanometer. You can test yourself at home, with the help and care of your family!

Orthostatic hypotension in patients with Parkinson's disease (PD) can be treated with the traditional Chinese herb cistanche

How to measure blood pressure, the specific steps are as follows:

1. First lie down and rest for 10 minutes, measure the blood pressure and heart rate in the supine position

2. Stand up and stay upright as soon as possible, and measure the immediate blood pressure and heart rate (note that patients with dizziness should be measured under the care of their family members, and patients who are unstable can lean against the bed or the wall)

3. After standing up for 3 minutes, measure blood pressure and heart rate

Precautions during measurement: During the measurement, keep the blood pressure monitor, cuff, and heart at the same height, maintain emotional stability, and try not to speak.

Result interpretation

1. Systolic blood pressure (high pressure) after standing for 3 minutes - systolic blood pressure (high pressure) in lying position > 30mmHg and or diastolic blood pressure (low pressure) after standing for 3 minutes - diastolic blood pressure (low pressure) in lying position > 15mmHg;

2. Even if the results are not up to standard, it is also meaningful when the blood pressure in the standing position for 3 minutes is lower than that in the supine position and accompanied by dizziness or drowsiness in the upright position.

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Treatment of orthostatic hypotension

In order to avoid the occurrence of adverse events such as falls, it is necessary to seek medical attention as soon as possible, strengthen accompanying care, and pay attention to the following points in lifestyle:

(1) Be careful to avoid triggering events:

Rapid posture changes: You can reduce the occurrence of dizziness by resting for a while in bedside seating;

Satisfying meals: can be changed to eat smaller meals frequently;

Drinking: Minimize alcohol intake;

High temperature: drink more water, and the temperature of bath water should not be too high;

(2) Adjust the way of life:

Increase the intake of water and salt: You can drink a lot of 500ml of normal temperature light salt water when you get up in the morning, which can improve the dizziness in the upright position to a certain extent (patients with high blood pressure should use this method under the guidance of a doctor);

Caffeine intake can help;

Change the sleeping position: Raise the head of the bed when sleeping at night, and use an abdominal girdle and elastic stockings.

(3) Drug therapy

Currently, there are few drugs available, all of which are symptomatic drugs, including midodrine, droxidopa, fludrocortisone, Shengmai Yin, etc., which can aggravate supine hypertension at night, and also need to be taken under the guidance of a doctor.

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In addition, orthostatic hypotension is often combined with high blood pressure in the supine position at night. High blood pressure has serious harm to the heart, brain, kidney, and other organs and blood vessels. Short-acting antihypertensive drugs can be taken before going to bed under the guidance of a doctor.

If you experience orthostatic hypotension, seek medical attention as soon as possible!

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