Orthostatic intolerance--an expression of autonomic disfunction in Parkinson's disease

Orthostatic intolerance syndrome is an important issue, having multiple etiologies and being the result of an inadequate response to changing in body position, namely the transition from supine to standing, a process that causes a series of responses regulated by the autonomic nervous system.

The aim of this study was to create a profile of patients with Parkinson's disease and orthostatic hypotension, a form of orthostatic intolerance, identifying the risk factors for this condition.

We conducted a study on 41 patients with Parkinson's disease selected from 200 consecutive patients with orthostatic hypotension, hospitalized in Cardiology Clinic of Colentina Clinic Hospital which met the diagnosis criteria for orthostatic hypotension. In order to meet the inclusion criteria, all patients were evaluated according to a preset protocol: medical history, clinical and paraclinical examination, including neuro-psychiatric assessment and the orthostatic tolerance test.

The decline in standing blood pressure was related to the presence of hypotensive neurological drugs, especially Levodopa, in chronic treatment, but it was not influenced by age or cardiovascular co morbidities. There is an improvement in blood pressure both in supine and upright position at discharge when compared to admission values.

The degree of decrease in the standing blood pressure values was correlated with the presence of potentially hypotensive neurological drugs, particularly Levodopa treatment, with a favorable effect of administration of non-pharmacological treatment and changes made in chronic neurological treatment.