How I handle the low blood pressure that accompanies my Parkinson’s
Discovering how greater hydration can help prevent inadvertent 'naps'
My husband, John, was leaning over me and saying, “What happened?”
I looked up at him and said, “Why?” What I was trying to say is, “Why did you wake me up?” But I couldn’t get the words out.
Then my arms, which hadn’t tremored since my deep brain stimulation device was turned on almost two years ago, started rising in front of me, as if a magician were conjuring a rabbit out of a hat. That’s when I realized that this gorgeous deep sleep I was having was on top of all the shoes and boots in our mud room. It wasn’t an afternoon nap; I’d passed out.
Low blood pressure is common for people like me with Parkinson’s, but I’d never passed out before.
I’d always thought low blood pressure was a good thing. That may be because John has a family history of high blood pressure. In fact, one of our fun family routines is taking and comparing our blood pressures; we get great pleasure from this decidedly weird activity. John usually declares me dead at some point and checks to make sure I’m breathing. Oh, we’re easily amused!
Parkinson’s and certain Parkinson’s drugs can lower blood pressure. I spoke to my neurologist about my “nap,” and she asked me how I’d felt before I went down. That’s when I realized that not everybody gets a head rush when they stand up, nor do they have a buzzing in their ears or get so off balance they fling themselves across the room when they get out of bed. It’s good to talk to people and figure out what “normal” is.
My neurologist recommended a few changes; the main one was staying more hydrated. Drinking more water is easy, especially since I’ve bought some tablets and powders to make it taste more interesting. I make sure that I drink water while I exercise, and in between exercising, I usually go for tea or coffee because caffeine is apparently good for us folk with low blood pressure.
In the snack department, I always like coffee with a muffin, though; with water, it’s different. And inviting friends over for water doesn’t have the same appeal.
We eat healthfully, especially since John had a heart attack a few years ago. Low-fat, low-salt, fresh veggies, fish, and vegetarian meals are our go-to. That low salt thing probably isn’t doing me any favors, however, so recently, I’ve started salting my own food again. It feels strange, but I really don’t want to be caught napping on top of the boots and shoes again!
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.
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Comments
Brenda lipson
I’ve had low blood pressure as long as I can remember ( non PD), as do my daughter and my mom. I learned something from you today-I always get a “head rush” if I change position too fast. Didn’t know you can pass out without warning with low BP. Thanks for teaching me something new. And now I m going to get a big drink of water.
Norm Goldman
My wife, who has PD, has low blood pressure and she takes Midorine. She has fallen due to the low blood pressure.
Your recommendation of staying hydrated is right on the mark. There is also being careful when getting up in the morning and whenever getting out of a chair.
Tina B
My husband also suffers from low BP due to PD. He has taken Midodrine for a couple of years now and it does help. He takes the maximum dose, 10mg 3x a day but finds another thing that helps is an abdominal binder. It was recommended by his cardiologist, and it really does help.
Kenneth E. Galbraith
Developed Parkinson’s approx 7 years ago. Have hand tremors daily. Had a frightening experience two weeks ago where I was using the bathroom and suddenly I went crashing to the floor. Ended up in hospital for a day after many tests and bloodwork. My cardiologist came in next morning and took my BP lying in bed then took it again standing up…..my pressure dropped 40 pts between laying down and standing up. I need to take several seconds just sitting on side of bed in morning and standing still for a short period of time any other time while up and down. Have anyone had this type of problem with Parkinson’s?
Peter Lyons
Ken, yes I sometimes experience a drop in BP when standing after sitting or lying down for a while.
My Neuro calls this Orthostatic Hypotension. I haven't passed out from the drop in BP. I can feel it coming on and will sit or stop what I'm doing for a minute or two.
My Neuro has prescribed Pyridostigmine BR. This helps to minimize the drop in BP. It doesn't prevent it, but does help.
Might be something you can try to see if it helps.
Barry Block
I find that taking a 1 gram NACL (salt) tablet with 8 oz of water in the morning helps immensely.
Barbara Ernest
My wife had blood readings that fluctuated from very high to very low sometimes to the point I could not get a reading. Results were conveyed to her neurologist without much comment.
Diana Brown
Glad to see an article that is on PD related low BP. My husband has Parkinson's & the 2 related hypotensions. Orthastatic Hypotension (sitting to standing) sounds like what you have been experiencing like my husband. My husband, Lou had OH & Postprandial Hypotension (BP drop after eating) as well. In fact, the Postprandial has been very telling. I now take his pre-BP then wait a half hour up to 2 hours afterwards a meal (usually breakfast) and the drop is insane. The Neurologist has me doing his laying, sitting, and standing BP at 2 mins up to 5 mins apart. His sitting to standing is always a drastic change. I have learned over the last 3 years with intense falling to manage his low BP with salt in water or on food, gatorade zero (sugar has had an effect on him), and naps (laying down helps to raise the BP in addition to the Midodrine). One thing that one of his 3 neurologists told us is to not lye down for a couple of hours after taking Midodrine. Not sure why but thought I would pass that tip along. Not sure how low your BP goes but Lou's had gone as low as 60/41 before and has landed him in the ER. These falls are not to be taken lightly but can be managed with forethought especially with safely in mind. Stay close to walls, use a walker with a seat, grab stable things such as a door frame and not a moving door. Never grab refrigerator doors that can fall on you nor shelving. When you stand, stand for a long moment, preferably with a chair or couch behind you. Then march in place to get your circulation going. These are things we have learned to manage Lou's low blood pressure from physical therapists and doctors. If you do fall again and unfortunately hit your head hard, go to the ER because brain bleed can occur up to days or even weeks after a fall. Many think it's only right afterwards and that is not true. Look up the symptoms to have a checklist handy.
Wish you safety and no more falls.
Susan Baldwin
I am just recovering from my last drop of low blood pressure. Was having problems with siatica and the ER DR. added Flexerel to my regeime of drugs. Took two pills of the 3 I was to take on Saturday and when I got up on Sunday morning, both my blood pressure and blood sugar were low, but not too bad. I didn't think much of it at the time I was taking them. Was doing my log I keep a few minutes later, and that is the last I remember. I woke up on the floor about 25 minutes later, my glasses one way- my chair another and my head with a huge knot on it. Ended up in the ER again, but this time they put me in the hospital for 2 days and I am now wearing a heart monitor to be sure everything is okay that way. It is now Thursday and I still have a huge knot on my head and my face and eyes are all black and blue. Look like I've been in a fight and lost! Be careful when they add another med to your list of meds!!
Annette Joan Wayman
My husband (pd) has always had high blood pressure, but last week his blood pressure dropped to 86/54. It stayed below the normal range for a few days. His cardiologist took him off of all of bp medications. Within a week, his blood pressure shot back up to over 201/86 and we are starting to add those bp medications as needed. Drinking more water is a challenge with him, but due to the fact that he has so many medications to take, that's usually not a problem.
Manuel Fernandez
My case was quite complicate on this regard. My blood pressure is rather erratic along the day and on the low phase can get as low as 50/100. The main problem happened whenever I had to take a Sinemet tablet when my pressure was low. The consequence was a sincope varying from mild to very serious. At best, I had a minor loss of consciousness for a couple of seconds. At worst, I simply collapsed and was unconscious for well 5 to 10 minutes. I solved the problem by measuring my pressure before taking a tablet plus always avoiding taking it after lunch, a time prone to produce a post-prandial sincope, as my neurologist explained.
Eric Lawes
70 year old retired anaesthesiologist. Diagnosed PD 18 months ago. On Madopar. Introduced midodrine after orthostatic hypotension became insufferable. Symptoms were ache across the shoulder, visual disturbances, lower back ache and measured standing BP 50/30. I don’t think standard BP machines measure lower than this. Eased by sitting or laying down (embarrassing in restaurants) 😳.
Had to discontinue ramipril. Drinking water helped a little. Salt raised morning Bp to 150/90, so stopped that. Midodrine held a lot but I avoid it in the evening.
Robert Womack
My name is Robert, I am 75, soon to be 76, I moved from the USA to live in Thailand with my Thai wife in a house we built in Eastern Thailand in the District of Yang Chum Noi, in the Sisaket Province. My wife is from a family of farmers so we eat lots of fresh vegetables from the farm near by as well as grow some in our backyard.
I had developed hypertension diagnosed in 2015 and was put on medication. Moreover, after being diagnosed with Parkinson’s I take Carbidopa 25 mg / Levodopa 100 mg 3 or four times a day every five hours. However, as my Parkinson’s subtly progressed, at first I was taking 100 mg of. Losartan and 12.5 mg of Chlorthalidone but two years after being diagnosed with Parkinson’s, I began to notice my Bp was going down and I was feeling it as occasional dizziness. So, I dropped my Losartan to 50 mg Then in my third year of Parkinson’s, I not only had more orthostatic hypotension but feeling close to passing out. My blood systolic pressure was in the 90s but and equally low was my diastolic pressure at 60 mmhg. So, on my own advice (I find my primary care physicians at the VA to be not as bright or even listen well enough ro make an informed decision about my health), I stopped all Bp medication but monitor my blood pressure religiously. My Bp seems to be fairly stable taken three times and averaging around 125/75. I exercise three time a week running and walking at least 5 miles, sometimes more. Additionally, I life weights three times per week.