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Orthostatic hypotension predicts motor decline in early Parkinson disease

Orthostatic hypotension is increasingly reported as a risk factor for development of late-stage disease features in Parkinson disease. Less is known about its significance in individuals with early Parkinson who are often targeted for neuroprotective trials.

Using data from the CALM-PD trial ( n=275 ), researchers explored whether early orthostatic hypotension predicts a decline in the Unified Parkinson's Disease Rating Scale ( UPDRS ) II ( activities of daily living ) or UDPRS III ( motor ) score after 102 weeks.
Researchers also explored risk factors for worsening orthostatic hypotension over a nearly 2-year period.

After controlling for age, disease duration, gender, study drug, change in mini-mental status exam score, Levodopa equivalent dose, and baseline UPDRS II or III score respectively, the degree of orthostatic hypotension at enrollment was associated with a worsening in UPDRS motor score ( t = 2.40, p = 0.017 ) at week 102 but not with UPDRS ADL score ( t = 0.83, p = 0.409 ).

Worsening in orthostatic hypotension during the study was associated with longer disease duration ( t = 2.37, p = 0.019 ) and lower body mass index ( BMI ) ( t = -2.96, p = 0.003 ).

In conclusion, baseline orthostatic hypotension is a predictor of UPDRS motor decline in individuals with early Parkinson disease and should be accounted for in clinical trial design.
Low BMI may predict orthostatic hypotension in Parkinson disease. ( Xagena )

Kotagal V et al, Parkinsonism Relat Disord 2016; 32: 127-129