[Early diagnosis of orthostatic hypotension in idopathic Parkinson's disease]. / Wczesna diagnostyka niedocisnienia ortostatycznego w idiopatycznej chorobie Parkinsona.

Autonomic dysfunction in idiopathic Parkinson's disease (IPD) is common and occurs in 70% of patients. The aim of the study was to evaluate autonomic mechanisms regulating cardiovascular system during tilt up test in IPD patients. The examination was performed in 35 patients with IPD (26 male and 9 female, mean age 60 +/- 9) and matched with gender and age 35 controls subjects (healthy volunteers, mean age 59 +/- 9). Patients were divided into two groups: group I--early stage of disease (n = 20) and group II--advanced stage of the disease (n = 15). The tilt test in IPD patients and in the control group lasted 3 minutes. In both groups tilt test was performed with a head-up tilt position of 60 degrees (tilt table Manumed, Netherlands). In both groups 30:15 ratio were lower than in the control group 1.03 +/- 0.08, 0.97 +/- 0.09 v 1.23 +/- 0.1 respectively (p = 0.001). In the second group the heart-rate variability after the tilt test was lower 6.2 +/- 4/min than in the control group 10.2 +/- +/- 1.9/min and group I 8.8 +/- 4/min (p = 0.01). The decrease of the systolic pressure in response to the tilt test was the highest in group II (16 +/- 14 mmHg), in the control group 4 +/- 7 mmHg, in group I 13 +/- 11 mmHg (p = 0.001). Ortostatic hypotension in IPD occurs in 36% of patients in an early stage and in 47% of patients in an advanced stage of the disease. The use of the tilt test enables the early diagnosis of cardiovascular disturbances in IPD.