Session Information
Date: Wednesday, September 25, 2019
Session Title: Non-Motor Symptoms
Session Time: 1:15pm-2:45pm
Location: Agora 3 West, Level 3
Objective: To assess the prevalence of transient orthostatic blood pressure (BP) changes and their influence on falls, syncope and orthostatic symptoms in Parkinson’s disease (PD).
Background: Orthostatic hypotension (OH) is a common, disabling non-motor feature in PD, defined as a sustained BP fall after 3 minutes standing. Transient BP falls within the first minute upon standing negatively influence morbidity and mortality in the geriatric population. However, their prevalence and impact on major clinical outcomes in PD is unknown.
Method: 167 patients with PD who underwent cardiovascular autonomic function tests under continuous non-invasive heart rate (HR) and BP monitoring at the Innsbruck Medical University between 2007 and 2016 were retrospectively studied.
Results: OH occurred in 16% of patients, while transient orthostatic BP changes within the first minute of standing in 20%, the combination of both was present in 6% of patients. Neither OH, nor transient orthostatic BP changes or the combination of both were associated with an increased frequency of falls (p: 0.082), syncope (p: 0.473) or orthostatic symptoms (p: 0.235) in the 6 months preceding or following cardiovascular autonomic function testing. At multivariate analysis, history of falls was associated with a more advanced H&Y stage (OR: 2.6, p: 0.001) and history of syncope (OR: 61,6, p<0.001). History of syncope was associated with a greater systolic (p<0.001) and diastolic (p=0.05) BP fall within 30s standing. History of orthostatic symptoms was associated with a greater systolic BP fall (p: 0.015) 15s after standing.
Conclusion: Transient orthostatic BP falls are more frequent than OH in PD. Lower BP values within 30s upon standing indirectly increase the risk of falls, by increasing the risk of syncope. A standing test under continuous HR and BP monitoring contributes to the identification of a modifiable risk factor for syncope and falls in PD.
To cite this abstract in AMA style:
A. Fanciulli, N. Campese, G. Goebel, J. Ndayisaba, S. Eschlboeck, C. Kaindlstorfer, C. Raccagni, R. Granata, U. Bonuccelli, R. Ceravolo, W. Poewe, G. Wenning. Transient orthostatic blood pressure changes in Parkinson’s Disease: impact on falls, syncope and orthostatic intolerance [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/transient-orthostatic-blood-pressure-changes-in-parkinsons-disease-impact-on-falls-syncope-and-orthostatic-intolerance/. Accessed June 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/transient-orthostatic-blood-pressure-changes-in-parkinsons-disease-impact-on-falls-syncope-and-orthostatic-intolerance/