I sometimes feel dizzy when I stand up, and my vision is blurry. Could this be related to my PD?

According to an article in "Every Victory Counts," an estimated 30 - 50% of people living with PD experience neurogenic orthostatic hypotension (nOH). This is a condition in a larger category called orthostatic hypotension, also known as postural hypotension. Neurogenic orthostatic hypotension is caused by autonomic nervous system dysfunction and causes people to feel faint when they stand or sit up. The prevalence increases with both age and the number of years living with PD.

OH is a substantial fall in blood pressure within 3 minutes of standing. OH can reduce blood flow to organs above the heart, most notably the brain, and its symptoms can profoundly impact your quality of life. OH is more common in older adults, and certain medications, dehydration, varicose veins, severe anemia, and heart disease can lead to OH. It can also be related to the nervous system, PD, pure autonomic failure, and other types of autonomic dysfunction.

Although nOH is relatively common, not everyone will experience symptoms. For that reason, people living with PD should be screened, even if they have no symptoms.

Neurogenic orthostatic hypotension can appear with or without symptoms. The typical symptoms include lightheadedness, dizziness, blurry vision, and fainting when there is a significant drop in blood upon standing up. Symptoms almost always occur when standing up, less frequently when moving from standing to sitting, and decrease when lying down. People with nOH may also experience weakness, fatigue, leg buckling, headaches, neck and shoulder discomfort, and shortness of breath.

Often, mornings tend to be the most difficult, as nOH symptoms are aggravated by overnight urination, which is common in PD. It is treatable. Treatment aims to reduce symptoms and improve your quality of life. Management includes correcting aggravating factors, lifestyle changes, and medication.

For more information, see the article "Neurogenic orthostatic (nOH) in Parkinson's" in Every Victory Counts by the Davis Phinney Foundation at www.davisphinneyfoundation.org.