title: Severity of orthostatic hypotension in the course of Parkinson's disease: no correlation with the duration of the disease.
abstract: BACKGROUND
  Orthostatic hypotension (OH) is a common issue in Parkinson's disease (PD), affecting about 30%-40% of PD patients. Symptoms of OH include lightheadedness, dizziness, postural instability, vertigo and blurred vision. OH considerably contributes to disease burden and reduced quality of life for PD patients.
  
  
  OBJECTIVE
  To determine whether the severity of OH in PD advances significantly with the duration of the disease.
  
  
  METHODS
  For 106 PD patients lying-to-standing orthostatic tests were performed to evaluate orthostasis. Severity of OH was measured as maximal drop of systolic blood pressure (SBP) after postural challenge, as the mean of three measurements. The relationship between the maximal drop of SBP and the duration of PD was tested applying ANOVA. Consecutively, 64 patients under regular ambulant supervision received appointments to evaluate their orthostasis repeatedly. From these patients a separate cohort was set up to investigate OH progression in the course of PD.
  
  
  RESULTS
  The lack of a correlation between the severity of OH in PD and the duration of the disease was determined (p = 0.064). The long term analysis for the patients under regular ambulant supervision demonstrated that the severity of OH does not advance in the course of PD in a statistically significant manner (p = 0.83).
  
  
  CONCLUSIONS
  OH does not appear to be a symptom only of the late stage of PD. The presence of OH along with early motor signs does not necessarily point to multiple system atrophy.
authors.affiliation: Parkinson-Klinik Wolfach, 77709 Wolfach, Germany.
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Jost
authors.affiliation: Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, 50009 Kaunas, Lithuania. Electronic address: sarunas.augustis@gmail.com.
authors.forename: Sarunas
authors.initials: S
authors.lastname: Augustis
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure; D018450:Disease Progression; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000150:complications*; D012720:Severity of Illness Index; D013223:Statistics as Topic
keywords: Autonomic dysfunction; Orthostatic hypotension; Parkinson's disease; Progression of the disease