A primer on orthostatic hypotension and a question

I've been increasingly troubled by the near fainting spells caused by my orthostatic hypotension. I think Washington's summer heat and humidity has something to do with it.

I've done a good bit of research on this and put together a "primer on orthostatic hypotension" for my own use. I ran it by the blood pressure specialist I've been dealing with and he said it was great. To check it out, here's the link -- bit.ly/2aHu0Qj or parkinsonsand5htp.blogspot....

All of the reports on OH say that it hits patients when they change position such as going from sitting to standing. But with me, the attacks most commonly occur when I've been standing for a while. My Dr. says this is unusual. I would be interested in hearing if others have experienced OH attacks that were not caused by a change in position.

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  • Hi ive been reading your comment, i dont get those kind of dizzy spells when changing position but i do get the fainting spells when my im feeling tired its like my whole system starts to shut down i feel sick like vomiting and very very dizzy indeed. Dont know whether its the same thing or not. It gets so bad that i have to lie down, otherwise it feels as if im dying.

  • Yes been having a lot of trouble with this lately. Mine is when I stand but also after I've walked a short distance. It's the worst symptom I think. You never know when it's going to hit. If there's not a chair to sit in I'm in real trouble, like the grocery store. I took fludrocortisone for a while, but it doesn't really help. In fact I think it makes it worse. I'm afraid to go anywhere alone anymore.

  • I had it for years. It was intermittent in nature but was aggravated by dehydration. I needed more salt and water. I further was tested via a tilt table test and diagnosed as neurocardiogenic syncope.

    Alter six years of taking Azilect I had some improvement in the incidence and severity upon discontinuing Azilect.... But it's still a pontetial problem at anytime including when I least expect it. Bummer

  • I have been having dizzy spells and near faints for several years and are the reason that I stopped driving. I am often sitting when I get such a spell; it comes without warning and comes on in waves. They do not happen as a result of any change in position. I wasn't taken very seriously by my doctors for a long time; my BP was typically about 110/70 which is a good healthy pressure, but then the attacks got much worse and I was measured at 94/63 so was put onto Fludrocortisone. I think this has helped but hasn't stopped the attacks altogether. Before Fludrocortisone, I had to lie down quickly for a while to recover, but now just getting my head down seems to be enough. Strangely, they rarely strike when standing, though on occasions they do. This makes me very wary of going anywhere that I cannot sit or lie down immediately.

    I have had PD for 21 years and take Madopar (Levodopa+Benserazide) 100mg/25mg; 1 every two hours.

  • The fludrocortisone will elevate your blood pressure and thus mitigate the effect of these attacks, but does not address the root cause, whatever it may be.

  • The root cause is assumed to be a side effect of the Madopar. My BP is naturally on the low side of normality which is fine until something causes it to fall further. I am starting on Mucuna Pruriens in the hope of cutting down on Madopar - crossing fingers!

  • Gleeson you allude to but don't specifically mention post prandial hypotension. I believe I sometimes get BP drop following meals.

  • Orthostatic hypotension is the inability of the autonomic nervous system to properly maintain blood pressure upon standing. If this is happening subsequent to standing it is definitely not what is usually considered to be OH, and you should direct your research to causes of "loss of blood pressure *while* standing".

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