Orthostatic Hypotension in Parkinson’s Disease: The Relation of Blood Pressure Tests and Symptoms in Daily Life

Background: Orthostatic hypotension (OH) is common in Parkinson's disease (PD), but the relation between the results of orthostatic blood pressure tests and orthostatic symptoms in daily life is not clear. Methods: We performed a cross-sectional study in an incident nontertiary care cohort of PD patients with additional recruitment of PD patients from our own outpatient clinic. We recruited sex- and age-matched controls. All participants underwent orthostatic blood pressure tests using continuous blood pressure measurements. Orthostatic symptoms experienced in daily life were assessed using autonomic symptom questionnaires (SCOPA-AUT and COMPASS-31). Results: A total of 83 PD patients and 35 controls were included. Mean patient age was 69.2 years (standard deviation [SD]: 10.0). Mean disease duration was 6.6 years (SD, 0.8). The estimated prevalence of OH in PD was 24.1% (95% confidence interval: 16.2–34.3). There was no significant difference between PD patients with and without OH regarding reported daily orthostatic symptoms. Alternative OH criteria did not substantially improve this. Conclusions: Perceived orthostatic symptoms in daily life have no clear association with the results of a single orthostatic blood pressure test. Better diagnostic strategies are needed.