The Heart Of The Matter: Cardiovascular Effects Of Parkinsons Disease
It has long been understood that Parkinsons disease does not just cause movement symptoms, but also causes a litany of non-motor symptoms with effects throughout the body. One of the organ systems that is affected is the cardiac system, encompassing the heart, as well as the major and minor blood vessels. I received this topic as a suggestion from a blog reader and we will be discussing this important issue today. Please feel free to suggest your own blog topic.
Medication Used For Treating Parkinsons
Low blood pressure can also be caused by medication used for the treatment of Parkinsons disease. This is especially associated with medications used for elevating the motor symptoms .
The most commonly used drugs that are associated with blood pressure include carbidopa and levodopa. These drugs are used to treat tremor and muscle stiffness. But their frequent use is reported to widen blood vessels and leads to fall in blood pressure 00053-6/fulltext” rel=”nofollow”> 8).
Pharmacological Options For Treating Hypotension
If these subtle lifestyle changes don’t help sufficiently, your doctor may consider prescribing you medications that will increase your blood pressure by increasing constriction within blood vessels as well as blood volume, like:
- Droxidopa
- Proamatine
- Fludrocortisone
As with almost any medication, it may take some experimentation before you find the drug that works well for you without causing unpleasant side effects.
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More Water And Salt: Simple Steps To Battle Low Blood Pressure
Increasing the amount of water you take can do wonders for your low blood pressure, especially if you were drinking too little initially. More salt in your diet is another pretty effective strategy as you’ll know, since you’ll have heard that people with high blood pressure need to stay away from sodium. Though salt will get your blood pressure up, don’t binge on salty foods without asking your doctor, as it can have other adverse effects, on your kidneys for instance.
How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid bath mats on the floor or install wall-to-wall carpeting.
- Lighting: Make sure halls, stairways, and entrances are well-lit. Install a night light in your bathroom or hallway and staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen: Install non-skid rubber mats near the sink and stove. Clean spills immediately.
- Stairs: Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
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Understanding The Neurologic Control Of The Cardiac System
Before we explore this issue, lets first learn a bit about the autonomic nervous system and about the cardiac systems place within it. The ANS is part of the peripheral nervous system, a network of nerves throughout the body. The ANS exerts control over functions that are not under conscious direction such as respiration, heart function, blood pressure, digestion, urination, sexual function, pupillary response, and much more. The ANS is further subdivided into the parasympathetic nervous system and the sympathetic nervous system. Both the parasympathetic and sympathetic nervous systems regulate most major organs. Often, they have opposite effects, with the sympathetic nervous system activating a system and the parasympathetic system calming it down.
One of the systems controlled by the ANS is cardiac regulation. Blood pressure sensors, known as baroreceptors, reside in the heart as well as in the carotid artery, the major artery in the neck. If the baroreceptors sense a change in the blood pressure, a signal is sent to particular areas in the brain. From there, the autonomic nervous system sends signals to the heart to control heart rate and cardiac output. Signals are also sent to the blood vessels to change the size of their diameter, thereby regulating blood pressure.
Impaired Ans Response To Standing In Noh
In patients with PD and nOH, autonomic dysfunction causes blood pressure to fall upon standing, due to an inappropriate NE response to postural change. Orthostatic hypotension has been defined as a drop in SBP of at least 20 mmHg or a drop in diastolic blood pressure of at least 10 mmHg after 3 minutes of standing. There is often a loss of the cardioacceleratory response too. Non-neurogenic causes of orthostatic hypotension are also common in patients with PD, and contribute to blood pressure drop. These non-neurogenic causes of orthostatic hypotension should be identified first, and include dehydration, medications, and cardiac pump failure. A clinical diagnosis of nOH can be made when these non-neurogenic causes of persistent orthostatic hypotension are excluded, and can be confirmed through autonomic testing and plasma NE levels.
In PD, autonomic dysfunction is mainly a result of cardiac sympathetic denervation with inadequate activation of NE pathways, and also baroreflex failure. This can emerge during the course of PD or can occur early in its course. Parkinsonism due to multiple system atrophy is also accompanied by prominent autonomic dysfunction, but nOH results from failure of central NE pathways.,
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Change Your Posture More Slowly
More tips to help you change your posture more slowly include:
- When you get up, don’t immediately begin walking, but wait a while
- Rise from a chair or bed slowly rather than suddenly
- When you get up from bed, rise into a sitting position and maintain that for a while before you stand up
- Bend down and reach for things slowly, if you have to do it at all
Description Of The Population
Ninety one consecutive patients years 48 women and 43 men) entered the study. Twenty one patients were in stage I, 49 in stage II, 19 in stage III, and two in stage IV of the Hoehn and Yahrs classification. All patients received levodopa at a mean daily dose of 682 mg. Forty three patients were also treated with bromocriptine and five received lisuride. Some patients were taking other antiparkinsonian drugs such as anticholinergic drugs or selegiline . Eleven patients had arterial hypertension and were treated with diuretic drugs , angiotensin converting enzyme inhibitors , or calcium antagonists . No patients were taking any antihypotensive drugs and 30 received domperidone mg).
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Monitor Your Blood Pressure
You may find it useful to keep a diary of what triggers your symptoms and what makes them better or worse. This will help manage the problem.
If you have low blood pressure, you may need to tell the relevant driving authority, depending on what you drive.
At the time of printing, the government website states that you need to tell the DVLA in England Scotland and Wales or the DVA in Northern Ireland, if treatment for blood pressure causes side effects that could affect your ability to drive.
Please check with your relevant authority if you have problems with your blood pressure, as the rules may have recently changed.
Remember that you must contact your relevant driving licensing agency when you are diagnosed with Parkinsons.
Whats Hot In Pd If You Are Dizzy Or Passing Out It Could Be Your Parkinsons Disease Or Parkinsons Disease Medications
This 3-page article, with references, is a personal statement by Dr. Okun describing the mis-diagnoses Parkinsons patients can be given when visiting the ER for symptoms of dizziness or syncope outlining what defines a proper diagnosis of orthostatic hypotension, its frequency in people with Parkinsons, medication and lifestyle changes that can help.
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Orthostatic Hypotension And Parkinsons: Could Sitting Up Be Affecting Your Memory
Orthostatic hypotension is among the most common non-motor symptoms in Parkinsons disease with prevalence reported as high as 53%. Yet, accurate diagnosis and management can often elude patients, who may be sent to a variety of specialists, including cardiology for management of fluctuations in blood pressure.
Both hypertension and hypotension contribute to cognitive decline, and a combination of vascular risk factors during an individuals lifetime could accelerate functional cognitive loss later in life. According to some researchers, both elderly and younger individuals with orthostatic hypotension show relative deficits in verbal memory and sustained attention, both of which are predictors of subsequent cognitive decline that is greater than would be expected in the context of normal aging. Orthostatic hypotension, when it occurs in Parkinsons disease, is a sign of autonomic dysregulation. A better understanding of OH by patients and professionals treating Parkinsons patients is important as delayed treatment of fluctuating blood pressure can result in injuries from falls and also be associated with reversible cognitive decline.
Symptoms of OH include lightheadedness, fatigue, neck pain, presyncope, and syncope (syncope is a temporary loss of consciousness caused by a fall in blood pressure.
Dr. Tony Gil, frequently provides patient education seminars
Q: What are symptoms that patients should report to their neurologist that might indicate a diagnosis of OH?
What Is The Outlook For Persons With Parkinsons Disease
Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.
Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.
The future is hopeful. Some of the research underway includes:
- Using stem cells to produce new neurons, which would produce dopamine.
- Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
- Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.
Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.
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Hypertension And Diagnosis Of Parkinsons Disease: A Meta
- 1School of Public Health, Dalian Medical University, Dalian, China
- 2Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Ningxia, China
- 3Laboratory of Neurobiology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States
- 4Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
Background: Hypertension has been associated with cognitive dysfunction in the general population and patients with Alzheimers disease . However, there are contradictory data regarding the potential association between hypertension and diagnosis of Parkinsons disease , the second most common neurodegenerative disorder after AD. The purpose of this meta-analysis is to synthesize data from cohort studies to explore the potential association between preexisting hypertension and subsequent PD diagnosis.
The findings of this meta-analysis suggest that hypertension may be a risk factor for motor stage PD, which may provide novel insights into the etiology and pathogenesis of this neurodegenerative disorder. However, large-scale well-designed studies that consider various confounders are still needed to further verify and clarify the association between hypertension and PD diagnosis.
Orthostatic Hypotension In Patients With Parkinsons Disease And Atypical Parkinsonism
This article outlines a study which reviewed current evidences on epidemiology, diagnosis, treatment, and prognosis of orthostatic hypotension in patients with idiopathic Parkinsons disease and atypical parkinsonism. Conclusions include recommendation for further study of OH and routine screening for timely diagnosis and further assessments beyond the recommended 3 minute postural challenge currently used.
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What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
How Is Parkinsons Disease Treated
There is no cure for Parkinsons disease. However, medications and other treatments can help relieve some of your symptoms. Exercise can help your Parkinsons symptoms significantly. In addition, physical therapy, occupational therapy and speech-language therapy can help with walking and balance problems, eating and swallowing challenges and speech problems. Surgery is an option for some patients.
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What About High Blood Pressure
High blood pressure is much more common in the general population than low blood pressure. It can lead to serious conditions such as stroke and heart attacks, but prompt treatment can avoid such complications.
Parkinsons does not cause high blood pressure, although people may have it as an unrelated condition. It can be effectively treated, but a careful balance has to be found so that low blood pressure does not result.
Effects Of Parkinsons Disease On Blood Pressure
This short web page explains the physical operation of blood pressure in the body, symptoms of low blood pressure and when they are most likely to occur, why low blood pressure is dangerous, medical treatments and lifestyle strategies to cope with low blood pressure, and a reminder that low blood pressure can affect the ability to drive safely.
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Can A Tricyclic Anti Depressant Be Used With Parkinsons Disease
If taken in combination with certain classes of PD meds, these medications could result in dangerous increases in blood pressure and agitation Although classified as a tricyclic anti-depressant, it can also block dopamine receptors Medications to be avoided or used with caution in all patients with Parkinsons disease
Tips: Avoiding Neurogenic Orthostatic Hypotension
- Drink lots of water and other fluids, at least one cup with meals and two more at other times of the day.
- Regularly practice gentle exercise and avoid long periods of inactivity.
- Eat small, frequent meals. Reduce alcohol intake and avoid hot drinks and hot foods.
- After consulting your doctor, increase your salt intake by eating prepared soups or pretzels. Note: for people with heart disease, this should be avoided.
- If you expect to be standing for a long period of time, quickly drinking two eight-ounce glasses of cold water will increase blood volume and causes blood pressure to go up for several hours.
- Try wearing compression garments such as anti-gravity stockings.
- Do isometric exercises, like marching your legs slowly in place, before getting up.
- Shift slowly from lying to sitting and then standing.
Printing made possible with a grant from Theravance. Content created independently by the Parkinsons Foundation.
For more insights on this topic, listen to our podcast episode Understanding Neurogenic Orthostatic Hypotension.
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Low Blood Pressure In Parkinson’s Disease
This 2-page article discusses the frequency of orthostatic hypotension in those with PD, the cause, symptoms and several simple measures that can be used to restore normal blood pressure regulation, including medication evaluation, increase of fluids and salty foods, caffeine, frequent small meals, environment, clothing, slow position change, bed position and medication options.
What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage
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