Examination of orthostatic hypotension and its related risk factors in patients with Parkinson's disease

Abstract

Objective To investigate the incidence and risk factors of orthostatic hypotension (OH) in Parkinson's disease (PD) by Active Standing Test (AST) and Head⁃Up Tilt Test (HUTT). Methods A total of 54 patients with PD were admitted to The First Hospital of Hebei Medical University from February to September 2020. Blood pressure was measured by AST and HUTT, the incidence of OH detected by the two methods was compared. Montreal Cognitive Assessment (MoCA) and Mini⁃Mental State Examination (MMSE) were used to assess the cognitive function. Hamilton Depression Rating Scale⁃24 (HAMD⁃24) was used to evaluate depressive symptoms. Hamilton Anxiety Rating Scale⁃14 (HAMA⁃14) was used to evaluate anxiety symptoms. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality. Unified Parkinson's Disease Rating Scale (UPDRS) and its third part were used to assess motor and non⁃motor symptoms of PD. Modified Hoehn⁃Yahr staging was assessed for disease severity. Functional gastroenteropathy Rome Ⅲ diagnostic criteria to assess constipation. KINPAMOR was used to assess olfactory function. Univariate and multivariate forward Logistic regression analyses were used to analyze the risk factors for OH in PD. Results The incidence of OH detected by HUTT was higher than that detected by AST [62.96% (34/54) vs. 24.07% (13/54); χ²=19.048, P=0.000]. Logistic regression analysis showed that the levodopa equivalent daily dose (LEDD) of dopamine receptor agonists increased (OR=1.029, 95%CI: 1.007-1.051; P=0.010), constipation (OR=16.268, 95%CI: 1.213-227.972; P=0.035), the lower MMSE score (OR=0.606, 95%CI: 0.418-0.880; P=0.008), the higher UPDRS total scores (OR=1.303, 95%CI: 1.034-1.643; P=0.025) and the higher UPDRSⅢ score (OR=1.438, 95%CI: 1.041-1.986; P=0.027) were risk factors for OH in PD. Conclusions The incidence of OH detected by HUTT was significantly higher than that detected by AST in PD patients. The higher dosage of dopamine receptor agonist LEDD, constipation, the higher total UPDRS score, the higher UPDRSⅢ score and the lower MMSE score were risk factors for the development of OH in PD patients.

doi：10.3969/j.issn.1672⁃6731.2022.04.008