title: Orthostatic hypotension: a non-motor complication assessment in 82 patients with idiopathic Parkinson's disease in Phramongkutklao Hospital.
abstract: OBJECTIVE
  Parkinson's disease (PD) is one of the neurogenic etiologies of orthostatic hypotension, a non-motor symptoms complex, that tends to be under-recognized and under-treated leading to a major cause of disability for PD patients. This complication is associated with one or recurrent falls causing mortality and morbidity. To the authors' knowledge, there is no study about this condition in Thai PD population. The authors therefore aimed to determine the frequency, clinical and risk factors of orthostatic hypotension in PD patients treated in Phramongkutklao Hospital.
  
  
  METHODS
  The authors enrolled consecutive patients with idiopathic PD over a 10-month period. Supine and standing blood pressure (BP) were measured sequentially as the standard techniques. Orthostatic hypotension (OH) was diagnosed if there was a reduction in systolic or diastolic BP of at least 20 or 10 mmHg respectively within 3 minutes after standing. The authors analyzed for the frequency of this condition as well as determined the risk factors between the OH and non-OH groups.
  
  
  RESULTS
  The number of patients enrolled was 82 with the mean age of 69 years. The median duration of PD was 4 years. Eighty-five percent were in Hoehn & Yahr stage 1-3. Thirty-three patients (40.2%) had orthostatic hypotension and 70% of them were asymptomatic. By univariate and multivariate analysis, the risk factors for this condition were the longer duration of PD diagnosis, the more advanced staging and the use of selegiline.
  
  
  CONCLUSIONS
  The frequency of orthostatic hypotension among the present PD was 40.2%. The longer duration of disease, the more advanced stage of Parkinson's disease and selegiline usage were the factors associated with this non-motor condition.
authors.affiliation: Division of Neurology, Department of Medicine, Phramongkutklao Hospital and Medical College, Bangkok, Thailand. pasiripmk@gmail.com
authors.forename: Pasiri
authors.initials: P
authors.lastname: Sithinamsuwan
authors.forename: Patima
authors.initials: P
authors.lastname: Orrawanhanothai
authors.forename: Krisdar
authors.initials: K
authors.lastname: Thithum
authors.forename: Chesda
authors.initials: C
authors.lastname: Udommongkol
authors.forename: Parnsiri
authors.initials: P
authors.lastname: Chairangsaris
authors.forename: Yotin
authors.initials: Y
authors.lastname: Chinvarun
authors.forename: Samart
authors.initials: S
authors.lastname: Nidhinandana
authors.forename: Wanna
authors.initials: W
authors.lastname: Wongmek
authors.forename: Seema
authors.initials: S
authors.lastname: Suphakasem
authors.forename: Jithanorm
authors.initials: J
authors.lastname: Suwantamee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000145:classification / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D019338:Polypharmacy; D011187:Posture; D012307:Risk Factors; D012642:Selegiline / Q000009:adverse effects; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000978:Antiparkinson Agents; D012642:Selegiline