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Hypotension in Parkinson's patients attributable to disease, not levodopa

Last Updated: 2005-12-29 10:01:41 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Neurocirculatory abnormalities underlying orthostatic hypotension in patients with Parkinson's disease are not associated with levodopa therapy, researchers report in the December issue of Hypertension.

"The report," lead investigator Dr. David S. Goldstein told Reuters Health, "adds to accumulating evidence that Parkinson's disease is not just a movement disorder, from loss of dopamine in a particular brain pathway, but is also a disease of regulation of the cardiovascular system, from loss of norepinephrine - dopamine's son in a small chemical family - in organs outside the brain."

Dr. Goldstein and colleagues at the National Institutes of Health, Bethesda, Maryland investigated factors associated with orthostatic hypotension in 66 patients with Parkinson's disease. Thirty-six of the patients had orthostatic hypotension and 30 were free of the condition.

Among those with hypotension, 21 were receiving levodopa, 15 were not. The severity of orthostatic hypotension did not differ between those receiving and those not receiving the drug. 

However, say the investigators, low values for reflexive cardiovagal gain, sympathoneural responses, and noradrenergic innervation were strongly related to orthostatic hypotension.

Thus, concluded Dr. Goldstein, "the neurocirculatory abnormalities in Parkinson's disease do not result from treatment of the disease with levodopa but are actually part of the disease itself."



 

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