"Subclinical" orthostatic hypotension is associated with dizziness in elderly patients with Parkinson disease
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M E Hillen1, M L Wagner, J I Sage
1Department of Neurology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903-0019, USA.
Objective:
To investigate risk factors associated with subjective complaints of dizziness in 12 elderly patients with Parkinson disease (PD), in whom no obvious cause for this symptom could be found.
Design:
A case-controlled study, with patients prospectively recruited in a nonblinded fashion.
Setting:
Patients were seen by one physician at a neurology outpatient clinic between August 1993 and August 1994.
Subjects:
Thirty-six patients, all over age 65 years and all with PD; 12 complained of dizziness; 24 did not.
Interventions:
Patients and controls were screened for blood pressure changes, postural instability, motor severity, multiple sensory deficits, drug use, cardiovascular disease, and diabetes mellitus.
Main Outcome Measures:
An orthostatic decrease of systolic BP > 15 mmHg (odds ratio = 6.5; 95% confidence interval = 1.22 - 34.52; chi 2mh = 6.7; p < .01) and an orthostatic decrease of diastolic BP > 5mmHg (odds ratio = 11; 95% confidence interval = 3.15 - 38.39; chi 2mh = 7.14; p < .01) were significant risk factors for complaints of dizziness.
Results:
The only significant risk factors linked with dizziness were orthostatic decreases in systolic (15 mmHg) and diastolic (5 mmHg) blood pressure.
Conclusions:
An orthostatic decrease in blood pressure is associated with unexplained feelings of dizziness in elderly PD patients.