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Parkinson’s and Low Blood Pressure
Drops in blood pressure occur during sudden changes in position. These pressure drops can cause dizziness or falls. They can be treated with simple everyday measures or medication.
One in three people with Parkinson’s disease experience drops in blood pressure
Blood pressure is a measure of the pressure your heart uses to pump blood through your body. It fluctuates naturally throughout the day. It is balanced throughout the body, from the feet to the brain.
These pressure drops, caused by the transition from lying or sitting to standing, are actually drops in pressure in the brain.
They can cause several symptoms including:
- Feeling dizzy or light-headed
- Blurred vision
Why does my blood pressure drop when I change positions?
Blood pressure is controlled by various factors, including your arteries’ diameter, heart rate and your body’s total fluid volume. These factors are managed by the part of the nervous system responsible for controlling unconscious bodily functions.
This nervous system compresses the blood vessels in the lower part of the body when we are standing, so that the blood does not end up entirely in the feet and legs. This system regulates the pressure in the body, no matter your position.
Just like the black substance that controls movement, this part of the nervous system is also damaged in people living with Parkinson’s disease.
As a result, the blood pressure maintenance reflex system no longer works properly. The change from sitting or lying down to standing therefore sends blood to the feet and legs, depriving the brain of oxygen. This causes dizziness or fainting.
Can my medication cause these drops in blood pressure?
In most cases, these pressure drops go unnoticed by people living with Parkinson’s disease.
On the other hand, medications that treat Parkinson’s disease can cause drops in blood pressure. Of these, levodopa is most likely to cause sudden changes in pressure. Your neurologist may prescribe increasing doses of levodopa to reduce the impact of this side effect.
Is my blood pressure normal?
The blood pressure measurement consists of two digits. The first is the highest heart pressure, when it pumps blood through the body. This is called systolic pressure. The second number is the lowest pressure, when the heart is at rest between beats. This is called diastolic pressure.
Blood pressure is measured in millimetres of mercury (mmHg). This is the unit of measurement for blood pressure, just as kilograms are used for weight, or meters for distance.
When your doctor tells you that your pressure is 120/70, this means that your systolic pressure is 120 mmHg and your diastolic pressure is 70 mmHg.
Normal blood pressure is between 90/60 and 140/90. All measurements outside this range are classified as low or high pressure.
Do not worry if you get a higher or lower value than normal. A single measurement is not necessarily representative of your daily blood pressure. If you are concerned that your blood pressure is too high or too low, measure your blood pressure at different times of the day and several times a week. This will give you a more general and accurate picture of your blood pressure.
When should I tell my doctor?
If you experience symptoms of pressure drops, such as dizziness, or if your blood pressure readings are below 90/60, talk to your doctor.
They will check your pressure in different positions (sitting, lying down and standing) to determine how your pressure fluctuates.
When are these pressure drops most likely to occur?
Blood pressure drops are most common within an hour of taking levodopa because it affects the part of the nervous system that regulates blood pressure.
Right after meals, blood is redirected to the intestine for digestion.
Hot settings, such as hot baths, can also cause pressure drops, as blood vessels are dilated by the heat.
What can I do?
Here are some tips that may help:
- Take your time when you change position, especially when you stand up
- When you wake up, sit on your bed for a few minutes before standing
- Once standing, wait a few seconds before walking
- Do not stand still for long periods of time
- Do not stay in a hot place for too long
- Avoid excessive activity in hot weather
- Drink enough water
- Reduce your alcohol consumption
- Follow a healthy diet that is easy to digest
- Increase your salt intake after talking to a health care professional
- Use compression socks
What medications are available?
Midodrine helps to compress blood vessels and therefore increase blood pressure. It should be taken at the same time as levodopa tablets.
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