title: Orthostatic hypotension predicts motor decline in early Parkinson disease.
abstract: Orthostatic hypotension is increasingly reported as a risk factor for development of late-stage disease features in Parkinson disease (PD). Less is known about its significance in individuals with early PD who are often targeted for neuroprotective trials.
  
  
  
  Using data from the CALM-PD trial (n = 275), we explored whether early orthostatic hypotension predicts a decline in the Unified Parkinson's Disease Rating Scale (UPDRS) II (activities of daily living) or UDPRS III (motor) score after 102 weeks. We also explored risk factors for worsening orthostatic hypotension over a nearly 2-year period.
  
  
  
  After controlling for age, disease duration, gender, study drug, change in mini-mental status exam score, levodopa equivalent dose, and baseline UPDRS II or III score respectively, the degree of orthostatic hypotension at enrollment associated with a worsening in UPDRS motor score (t = 2.40, p = 0.017) at week 102 but not with UPDRS ADL score (t = 0.83, p = 0.409). Worsening in orthostatic hypotension during the study associated with longer disease duration (t = 2.37, p = 0.019) and lower body mass index (BMI) (t = -2.96, p = 0.003).
  
  
  
  Baseline orthostatic hypotension is a predictor of UPDRS motor decline in individuals with early PD and should be accounted for in clinical trial design. Low BMI may predict orthostatic hypotension in PD.
authors.affiliation: Department of Neurology, University of Michigan, Ann Arbor, MI, United States; Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, United States. Electronic address: vikaskot@med.umich.edu.
authors.forename: Vikas
authors.initials: V
authors.lastname: Kotagal
authors.affiliation: Department of Neurology, University of Michigan, Ann Arbor, MI, United States.
authors.forename: Christina
authors.initials: C
authors.lastname: Lineback
authors.affiliation: Department of Neurology, University of Michigan, Ann Arbor, MI, United States; Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, United States; Department of Radiology, Division of Nuclear Medicine, University of Michigan, Ann Arbor, MI, United States; University of Michigan Morris K. Udall Center of Excellence for Parkinson's Disease, Ann Arbor, MI, United States.
authors.forename: Nicolaas I
authors.initials: NI
authors.lastname: Bohnen
authors.affiliation: Department of Neurology, University of Michigan, Ann Arbor, MI, United States; Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, United States; University of Michigan Morris K. Udall Center of Excellence for Parkinson's Disease, Ann Arbor, MI, United States.
authors.forename: Roger L
authors.initials: RL
authors.lastname: Albin
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010300:Parkinson Disease / Q000175:diagnosis* / Q000209:etiology*; D011237:Predictive Value of Tests; D012044:Regression Analysis
keywords: Body mass index; Clinical trial; Orthostatic hypotension; Parkinson disease; Systolic hypertension