My subtype : Postprandial and orthostatic hypotension in Parkinson's disease. 1987

[aspergerian13]

An early study.

Postprandial and orthostatic hypotension in Parkinson's disease.

Micieli G, et al. Neurology. 1987.

ncbi.nlm.nih.gov/m/pubmed/3...

In this study, the 24-hour pattern of blood pressure (BP), heart rate, and urinary catecholamine (CA) excretion and the response of BP and plasma CA to the tilt test have been investigated in 13 untreated patients affected by Parkinson's disease (PD) and in 11 age-matched healthy controls.

Seven of the 13 PD subjects showed a fall of supine systolic BP greater than that in controls (ie, exceeding 20% of the preprandial value). A significant relationship was found in the PD group between the degree of postprandial hypotension and the 24-hour mean value of dopamine excretion. Eight PD subjects also showed orthostatic hypotension during the tilt test (performed in the morning hours) and in the postprandial phase.

Basal norepinephrine plasma levels of PD patients, as well as their percentage increases on standing, were within the range of the controls.

These data suggest the existence of a subtype of PD patient, characterized by a widespread impairment of cardiovascular responsiveness and bordering on syndromes of autonomic failure such as progressive autonomic failure or multiple system atrophy, or both.

PMID 3822130.

Also:

Central autonomic disorders.

Review article

Benarroch EE, et al. J Clin Neurophysiol. 1993.

ncbi.nlm.nih.gov/m/pubmed/8...

Central autonomic dysfunctions can be due to primary (degenerative) or secondary disorders. Autonomic failure (AF) may be a major manifestation of multiple system atrophy (MSA) and idiopathic Parkinson's disease (IPD). In both MSA and IPD, AF is almost invariably associated with neuronal loss in the intermediolateral cell columns....

In other words, my brass is grass. I have OH and PPH. For me, PPH is far more aggressive, annoying, wasteful of life energy. Tweaking dysautonomia ain't easy.

[Hikoi]

Is it really a sub type or part of the Parkinson syndrome? Perhaps it doesn't get talked about much because there is not really any treatment. I think you have read alot on this topic so you probably have read this article.

ncbi.nlm.nih.gov/pmc/articl...

Symptoms of abnormal autonomic-nervous-system function occur commonly in Parkinson’s disease (PD)......... Because PD involves postganglionic sympathetic noradrenergic lesions, the disease seems to be not only a movement disorder with dopamine loss in the nigrostriatal system of the brain, but also a dysautonomia, with norepinephrine loss in the sympathetic nervous system of the heart.

[aspergerian13 in reply to Hikoi]

Your reply is appreciated. Yes, Goldstein is well focused for some of us.

[alexask]

My first symptom was post prandial OH. But this has mostly gone away with a) exercise b) lowish carb diet. If I have carbs for breakfast then sit in an office all morning it comes back. Commiserations on the pulmonary arterial hypertension.

[aspergerian13 in reply to alexask]

Thanks for the reply. Yesterday I learned i have pph and oh.

[aspergerian13 in reply to alexask]

Alex,

What foods does your typical breakfast contain?

Have you found any worthwhile PPH diet books or webpages?

[alexask in reply to aspergerian13]

During the week, I will typically skip breakfast 3 days, and maybe have a duck egg and a piece of toast for the other two. Weekend's might have bacon and eggs. Pancakes on Sundays.

[aspergerian13 in reply to alexask]

Elucidation appreciated.