Orthostatic hypotension is a drop in blood pressure that happen when you go from a seated position or lying down to standing. Certain medications; including those for high blood pressure; dehydration and conditions such as heart disease increase this risk.

When orthostatic hypotension is related to a neurologic disorder like Parkinson's Disease, it's called Neurogenic OH, or nOH. Damage cause by nervous system disorders, including Parkinson's, can result in the nervous system not being able to make or release norepinephrine, a chemical that constricts blood vessels and raises blood pressure. This causes dizziness or lightheadedness.

nOH Symptoms
  »   Lightheadedness
  »   Dizziness
  »   Weakness
  »   Difficulty Thinking
  »   Headache
  »   Blurred or Dimmed Vision

Neurogenic OH tends to be underdiagnosed. It is usually identified because people get dizzy or start to black out when they stand up. Early in the Parkinson's Disease progression, you might not noticed the dizziness, but you may experience the foggy thinking or memory problems.

Managing nOH

If you become lightheaded upon standing, report it to your doctor. In general asking your doctor to screen you for nOH once a year is a good idea. This is done by taking your blood pressure while lying down and then standing. A drop of 20 points in the top number (systolic) or 10 points in the bottom number (diastolic) indicated nOH.

There are also several lifestyle strategies you can try:
  »   Drink more fluids to keep hydrated
  »   Consume more salt and caffeine
  »   Wear thigh high support stockings. Compression garments can be effective in preventing OH
  »   Monitor your blood pressure
  »   Sleep with your head elevated between 10 and 30 degrees
  »   Change positions slowly, especially when rising from a seated to a standing position. Pause for several seconds between each movement
  »   Be aware of behaviours and circumstandce than can make nOH worse such as fever, drinking alcohol and meals with high carbohydrates

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