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Parkinson’s increases the odds of a dangerous waterfall, but prevention is key

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Wednesday, September 16, 2020 (HealthDay News)-The main cause of falls in the elderly is more common among Parkinson’s patients, and monitoring their condition may reduce their risk. New research shows

Have you ever felt dizzy or dizzy when you suddenly stood up? This is due to a sudden drop in blood pressure. A condition that doctors call orthostatic hypotension can cause fainting and falls.

According to a new study, people with Parkinson’s disease have doubled the odds of unconditional people who develop orthostatic hypotension, resulting in higher odds of dangerous falls.

However, “If we can monitor people’s blood pressure to detect this condition, we can control these blood pressure drops and prevent some falls that can cause great damage to people with Parkinson’s disease.” , Dr. Alessandra Fanciulli, the lead author of the study, explained. .. She belongs to the Innsbruck Medical College in Austria.

One US expert unrelated to the study agreed.

Waterfalls are “an important issue of Parkinson’s disease and are often ignored,” said Dr. Alessandro di Rocco. He directs the Northwell Health Movement Disability Program in Great Neck, New York. “Blood pressure management problems, especially episodes of hypotension, which are often associated with changes in position from sitting or lying down, are common in Parkinson’s disease and are not uncommon to cause fainting or faint episodes. “

According to Dirocco, the frequency and severity of falls can increase with the severity of Parkinson’s disease, often resulting in “fractures and other trauma.”

Physicians treating patients with Parkinson’s disease often underestimate the role of orthostatic hypotension in falls and are unable to provide appropriate medication, Dirocco added.

The new study was published on September 16th Neurology It also included 173 people with Parkinson’s disease who were referred to a doctor for dizziness and fainting. Four out of ten already had a history of falls, 29% of whom fell due to fainting.

This group was compared to 173 people of the same age who did not have Parkinson’s disease but had a condition called orthostatic intolerance. Orthostatic intolerance, when it is an upright symptom that subsides when lying down, causes symptoms such as vision problems, headaches, anxiety, fatigue, and weakness.

Both groups were tested for two types of orthostatic hypotension. “Transient” orthostatic hypotension occurs when you rise from a sitting or lying position and your blood pressure drops dramatically and returns to normal within about a minute. Classic orthostatic hypotension in which blood pressure drops within 3 minutes of standing up and then returns to normal.

Nineteen percent of people with Parkinson’s disease had classic orthostatic hypotension, but none of the other groups. The incidence of transient orthostatic hypotension was 24% in patients with Parkinson’s disease and 21% in patients with orthostatic intolerance.

After adjusting for other factors that may affect risk, researchers say that people with Parkinson’s disease are twice as likely to have transient orthostatic hypotension as people in other groups. I decided.

However, proper treatment reduced the risk.

According to Fanciulli’s group, treatment was prescribed to 18 of 39 patients with transient orthostatic hypotension. Nine used non-drug treatments, such as increasing fluid and salt intake, leaning their heads to sleep, and wearing wide compression belts. Of these 9 patients, 6 reported improvement in symptoms.

Six other patients were told to stop taking antihypertensive drugs (ACE inhibitors, diuretics or beta-blockers), and three patients said their symptoms improved after taking them.

Three people started taking so-called “adrenaline agonists” (midodrine in two cases and droxidopa in the other). Patients taking droxidopa reported improvement in their symptoms, according to Austrian researchers.

“These results are preliminary and require greater research, but these treatments that have been used for classical orthostatic hypotension also work for transient orthostatic hypotension. It suggests that it could be the target, “Fanciulli said in a news release of the journal.

Dirocco agreed. “Understanding the nature of these episodes can lead to effective treatments that can dramatically reduce the risk of fainting, falls and fractures,” he said.

For more information

The National Library of Medicine Orthostatic hypotension..

Source: AlessandroDiRocco, MD, Director of Northwell Health Movement Disorders Program, Great Neck, NY; Neurology, News Release, September 16, 2020

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