Low blood pressure when changing positions, such as standing from sitting, can be part of Parkinson's or a side effect of Parkinson's medications. Recognizing and treating low blood pressure can help prevent complications, such as fainting or falling.
Causes
Low blood pressure when changing positions (orthostatic hypotension) can be caused by Parkinson's or the medications used to treat it. Parkinson's affects a network of nerves — the autonomic nervous system — that controls blood pressure. In some people, especially those with advancing disease, this means that blood pressure drops when changing positions. Certain Parkinson's drugs, such as dopamine agonists and sometimes levodopa, also may cause low blood pressure.
Other conditions, such as dehydration or low blood count (anemia), as well as other drugs, including high blood pressure medications, fluid pills (diuretics) and certain antidepressants, also may lower blood pressure.
Evaluation
To see if blood pressure drops, doctors measure your blood pressure while you're lying down, sitting and standing. At the same time, they look to see whether you have symptoms of low blood pressure, such as lightheadedness or dizziness. If doctors are concerned about other conditions, they may check blood or urine tests, too.
Treatments
Treatment of low blood pressure consists of adjustments to diet and lifestyle, and sometimes medication changes as well.
The first steps in treating low blood pressure are dietary and lifestyle adjustments.
For diet:
- Increase water intake to at least six 8-ounce glasses per day.
- Add salt to your food or eat salty foods, such as canned soups (if your heart and kidneys are healthy).
- Avoid hot or alcoholic beverages as these can temporarily lower blood pressure.
- Eat multiple small meals throughout the day, rather than three large ones.
For lifestyle:
- Change positions slowly and cautiously.
- Avoid prolonged standing (or shift positions if you do).
- Drink a full, cold glass of water before standing up.
- Raise the head of the bed or use more pillows at night.
- Wear compression hose on your legs.
- Exercise regularly (without excessive sweating).
Review your medications with your doctor to see if any might be contributing to low blood pressure and should be adjusted. Sometimes, when diet and lifestyle changes aren't enough, medication may be prescribed to raise blood pressure. Northera (droxidopa) was approved in 2014 for treating orthostatic hypotension in Parkinson's and related conditions. For some people, other medications, such as Florinef (fludrocortisone) or ProAmatine (midodrine), may be used instead.
The medical information contained in this article is for general information purposes only. The Michael J. Fox Foundation for Parkinson's Research has a policy of refraining from advocating, endorsing or promoting any drug therapy, course of treatment, or specific company or institution. It is crucial that care and treatment decisions related to Parkinson's disease and any other medical condition be made in consultation with a physician or other qualified medical professional.