Parkinson’s Disease and Low Blood Pressure – What’s the Connection?

Parkinson’s disease is a progressive brain disorder that affects certain cells responsible for the production of dopamine, a neurotransmitter which governs body movement. The disease is usually recognized when body experience complications like shaking, rigidity, and difficulty with walking. In addition to these motor symptoms, the disease also strikes the body with some non-motor symptoms.

Low blood pressure is one of the most frequent non-motor symptoms of Parkinson’s disease. It is estimated that up to 40% of Parkinson’s patients have low blood pressure (1). Despite such a high prevalence, this sign of the disease is often poorly recognized and inadequately treated.

Parkinson’s disease and low blood pressure – what’s the link?

Low blood pressure is one of the most common non-motor signs of Parkinson’s disease that affects one in 5 people with the disease (2). Although the problem can appear at any stage, people with mid and late-stage of Parkinson’s disease are generally more affected.

For most patients, drop in the blood pressure happens early in the morning or after taking medication. For others, it can occur at any time of the day.

Research shows that lower blood pressure appears many years before the development of motor symptoms (3). Therefore, it is now being considered as one of the early warning signs of Parkinson’s disease development.

What happens in low blood pressure?

Low blood pressure or hypotension occurs when the blood vessels become wider and unable to constrict. This result in insufficient blood supply to all the organs of the body.

In Parkinson’s, the patient experienced low blood pressure when changing position. For example, from lying to sitting or from sitting to standing. This is known as postural hypotension. When it happens, the patient starts to feel dizziness, blurred vision, fainting, and an unsteady feeling. In this situation, walking can be troublesome; the patient can easily fall, which could lead to serious injuries.

Low blood pressure can also affect memory and thinking functions of the brain (4). Parkinson’s patient experience the difficulty in moment judgment; meaning they are confused where to move the leg or hand. Sometimes, these brain changes appear without feeling dizziness or blurred vision. The only way to be sure that these signs are the consequence of low blood pressure is to measure your blood pressure regularly.

What causes low blood pressure in Parkinson’s disease?

In Parkinson’s disease, the low blood pressure is frequently related to the following three reasons.

1. Parkinson’s disease itself

In most cases, Parkinson’s disease itself is the main cause of low blood pressure (5). This is due to the fact that when the disease developed, the autonomic nervous system of the body also gets affected. The autonomic nervous system is part of our brain system that automatically controls many bodily functions including heart rate and blood pressure (6).

In a normal situation, when you stand up after being lying down for a longer time, the heart has to take an extra effort to cope with the new position (from resting or relaxed state to active state). The blood pumping ability of the heart to the brain is increased in order to keep the blood flow and blood pressure in the normal range. But in Parkinson’s disease, this coping ability of the heart becomes impaired, and so blood pressure drops rapidly and it takes a much longer time to return to normal state.

2. Medication used for treating Parkinson’s

Low blood pressure can also be caused by medication used for the treatment of Parkinson’s disease. This is especially associated with medications used for elevating the motor symptoms (7).

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 (8).

3. Other medical conditions

Sometimes, low blood pressure occurs because of the use of high blood pressure medications. These medications are usually prescribed before Parkinson’s diagnosis. Apart from high blood pressure medications, some other drugs like antidepressants are thought to cause low blood pressure in patients (9).

How to deal with low pressure in Parkinson’s disease?

If you are a Parkinson’s patient, it is very important to keep your eyes open on your blood pressure. Monitor and measure your blood pressure on regular bases, even if you don’t feel any obvious signs. When taking blood pressure, do it in both seated and standing positions. It is good to take it 2-3 times a day. If you observed that your blood pressure is constantly low, talk to your caregiver immediately.

Here are some of the ways that can help you to maintain your blood pressure at a normal range.

• Drink a lot of water and avoid too much eating at once.
• If you have no issue with heart and kidney, increase the intake of salt in your food as it has been shown to elevate the blood pressure.
• Stop or reduce the consumption of alcohol and hot drinks. They widen the blood vessels and drop the blood pressure abruptly.
• Try to avoid excessive exercise as it can exacerbate the condition.
• Avoid changing your position suddenly. Take time to move from lying to sitting or from sitting to standing.
• Avoid standing for a long time.
• Consider the use of assistive devices like compression hose and an abdominal binder.

Concluding remarks

Low blood pressure is one of those non-motor signs of Parkinson’s disease that, if not handled properly, can seriously impact patient’s quality of life. If you are a Parkinson’s patient and having low blood pressure problem, talk to your doctor about it immediately. Your doctor may prescribe medication that elevates your blood pressure or alter your current medication regimen. In addition to medication, changes in diet and other lifestyle changes may help to keep your blood pressure at a normal range.

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Disclaimer: The information shared here should not be taken as medical advice. The opinions presented here are not intended to treat any health conditions. For your specific medical problem, consult with your health care provider.