Study On Orthostatic Hypotension And Its Related Factors In Parkinson's Patient

Objective: To investigate the clinical features and the incidence of orthostatic hypotension in patients with orthostatic hypotension in parkinson's disease,and analysis the effects of orthostatic hypotension on motor symptoms,non-motor symptoms and quality of life.Methods: Patients were consecutively recruited from 2014 to 2017 in neurology clinics of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine,The diagnosis of PD was made by UK Parkinson Disease Society Brain Bank Criteria.The general information and medication of 124 patients were collected by questionnaires,including personal information,course of disease,history of Present illness and medication history,past history,family history,etc.The severity of motor symptoms was evaluated using the Unified Parkinson's Disease Rating Scale(UPDRS),Non-motor symptoms were assessed using the NMSS That includes 30 items in 9 domains.Orthostatic hypotension was defined by head-up tilt test.Tests was performed in a quiet environment;patients rested in a supine position for 20 minutes before testing.A 60° head-up tilt was conducted for 45 minutes followed,blood pressure were measured at 1-minute intervals within 3 minutes,then after 3minutes was measured at 5-minute intervals,until 45 minutes.Results: The incidence of orthostatic hypotension in PD was 46.7%(58/124),the orthostatic hypotension within 3 minutes and delayed orthostatic hypotension accounted for 29%(36/58),17.7%(22/58),respectively;Compared with non-orthostatic hypotension group,in the motor symptom,orthostatic hypotension group appeared more serious axial symptoms(U=879.50,p=0.000),and the scores of PDQ39 were higher(U=826.00,p=0.008);non-motor symptoms,especially cardiovascular system symptoms correlated with other non-motor symptoms such as sleepdisorder(r=0.643,P<0.01),RBD(r=0.354,P<0.01),anxiety(r=0.457,P<0.01),depression,(r=0.484,P<0.01)and gastrointestinal(r=0.323,P<0.01).Conclusion: Orthostatic hypotension in parkinson's disease has a higher incidence;It can be an important indicator of rapid disease progression;OH easily leads to repeated falls,and affects the quality of life of patients.therefore,it is very helpful for patients of PD with orthostatic hypotension to improve balance function,quality of life,reduce the risk of wrestling and injury through clinical research of orthostatic hypotension.