How Blood Pressure Fluctuations Can Affect Parkinson’s Patients
I never thought much about my sister Bev’s blood pressure (BP) until I accompanied her to a dental appointment. The staff took her vital signs and told Bev, “Your blood pressure is a bit low today at 98/68 mmHg.” A normal BP for adults is usually in a range slightly less than 120/80 mmHg. The next time she visited the dentist, her BP was low again.
My sister has stage 3 Parkinson’s disease (PD), and she usually struggles with short-term memory, gait, and balance issues. Bev and I were curious about a possible relationship between her low blood pressure and PD.
I asked Bev if she ever felt dizzy or lightheaded. She said, “Yes, sometimes I do. When that happens, I just sit down and drink some water.”
According to the National Parkinson Foundation, people with PD “may experience low blood pressure (hypotension) at some point during their disease progression. In fact, one in five people with PD are affected by orthostatic hypotension, also called postural hypotension: low blood pressure that is experienced when changing positions (e.g., moving from lying down or sitting to standing up).”
Some PD medications can also lead to low BP, including levodopa, dopamine agonists (ropinirole, pramipexole), and monoamine oxidase inhibitors (selegiline). My sister takes selegiline. Any BP medications should also be carefully monitored by a physician.
Parkinson’s UK offers several tips for managing low BP with PD. These include getting up slowly from a reclined or seated position to prevent dizziness, drinking plenty of water to stay hydrated, eating smaller and more frequent meals, and moving around rather than standing or sitting in one position for a long time.
Bev eats several smaller meals throughout day, which also helps with her swallowing difficulties.
People with PD may also experience high BP, or hypertension. A 2013 study published in Brain and Behavior found that nocturnal hypertension is more common in Parkinson’s patients than in other patients. Study participants had their blood pressure checked every 30 minutes over a 24-hour period to catch any BP fluctuations.
Researchers concluded that, “Although hypotension is a severe risk factor for falling and syncope, we emphasize the importance of monitoring rather hypertension and fluctuating BP in PD patients that may lead to a variety of other undesirable conditions.”
Because BP fluctuation is common among those with Parkinson’s, it’s critical that patients or their caregivers frequently check this vital sign. Blood pressure monitors are available at many pharmacies and online stores, such as Amazon. Be sure to discuss any concerns with your primary healthcare provider and neurologist.
Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.
What does this mean:
we emphasize the importance of monitoring rather hypertension and fluctuating BP in PD patients
I was initially diagnosed with orthostatic hypotension before my PD was confirmed. The differential between sitting and standing averages 2030 points but can be as high as 50 points! To combat this, I take a 1 gram tablet of NACL (salt) 1 hour prior to getting out of bed. I then wear an abdominal compression belt most of the day. This keeps my BP around 100/70 standing. If it gets below that,, it becomes symptomatic. I also drink G2 (low sugar) Gatorade throughout the day and eat salted and roasted fava beans in the afternoon.
Michael Ernest, Sr.
My late wife had PD for over two decades but and experienced wide fluctuations but mostly so low, it was difficult to get a reading with an automated device. Most doctor office measurements were normal to low side.
My wife has hypotension. I check her blood pressure several times a day. She takes 5gm Midodrine 3x daily. And her Dr. put her on Gabapentine for back pain that she has had for years. Gabapentine lowers the blood pressure itself. So, the medication
doesn't serve the hypotension. I spoke to Ellen's Dr. that changes need to happen. Balancing act with Carbidopa/ Levodopa, Buspar, Remeron, Trazodone, Lorazepam 2mg, and a statin for cholesterol. I would like to hear your story and how you feel. Lee
I have been reading about BP fluctuations. My husband normally runs a low BP and was on medication to raise the BP. However a couple of times lately he was scheduled for an endoscope procedure. When he got t the office his BP had gone over 217/120. He was sent to the emergency room and eventually after an injection (what I do not know) it went down. Is this white coat syndrome or is something related to PD causing it? Is it dangerous? It has happened three times now.
Beth T Browne
I have had high blood pressure since my 60’s. I am now 85. I take my pressure daily. I was told by my movement doctor, and my heart doctor, that you can have high blood pressure from laying a period of time and when sleeping. I know this to be true, as it has happened to me. My heart doctor doesn’t want to increase my medicine for fear it could drop too low. This article doesn’t mention that.
On a recent 18 hour road trip my blood pressure went up to 191/107. Is this because I was changing positions from sitting to laying down throughout the trip?