Evidence map›Paper›PMID 25678194›Full record

Observational studyMovement disorders : official journal of the Movement Disorder Society2015

Orthostatic hypotension in Parkinson disease: how much you fall or how low you go?

Jose-Alberto Palma, Juan Carlos Gomez-Esteban, Lucy Norcliffe-Kaufmann, Jose Martinez, Beatriz Tijero, Koldo Berganzo, Horacio Kaufmann

3 registry-linked trialsAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Movement disorders : official journal of the Movement Disorder Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 105 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 5 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04510922 phase4completednot on this mapstarted 2019, after this paper: background citation

Technology-Based Objective Measures for Gait and Postural Assessment in Parkinson Disease Patients With Orthostatic Hypotension: Feasibility and Effect-Size Finding Study

TypeinterventionalSponsorAlberto Espay, MD, MScRan2019 to 2020Enrolled9ConditionsOrthostatic Hypotension, Idiopathic Parkinson DiseaseArmsDroxidopa 100 MG [Northera]
NCT05400174 narecruitingnot on this mapstarted 2021, after this paper: background citation

Effects of Blood Pressure on Cognition and Cerebral Blood Flow in Parkinson Disease

TypeinterventionalSponsorUniversity of California, San DiegoRan2021 to 2027Enrolled60ConditionsParkinson Disease, Orthostatic Hypotension, DysautonomiaArmsTilt table (upright position)
NCT06252376 nawithdrawnnot on this mapstarted 2025, after this paper: background citation

Effects of Blood Pressure on Cognition and Cerebral Hemodynamics in Parkinson's Disease

TypeinterventionalSponsorUniversity of California, San DiegoRan2025 to 2029Enrolled0ConditionsParkinson Disease, Orthostatic Hypertension, Cognitive Change, Cognitive ImpairmentArmsHead-up tilt table
3 · Its place in the literature

Who cites it

105 citing papers in PubMed, 5 syntheses or guidelines pooled it, 174 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Safety and efficacy of ampreloxetine in symptomatic neurogenic orthostatic hypotension: a phase 2 trial.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021
    Trial
  7. Trial
  8. Beyond blood pressure fall: a mechanistic framework for symptom generation in orthostatic hypotension.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  9. Orthostatic hypotension and complaints: not a clear-cut relation.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  10. Article
  11. Autonomic debate: symptoms are an optimal target for orthostatic hypotension screening and management. An argument in opposition.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  12. Symptoms are an optimal target for orthostatic hypotension screening and management: an argument in favor.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Review
  13. How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  14. Catecholaminergic storm and extreme blood pressure lability induced by combined levodopa/benserazide, selegiline, and piribedil in Parkinson's disease: a case report.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  15. Article
  16. Review
  17. Article
  18. Review
  19. Article
  20. Article

45 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Jose-Alberto PalmaDysautonomia Center, Department of Neurology, New York University Medical Center, New York, New York, USA.
Juan Carlos Gomez-Esteban
Lucy Norcliffe-Kaufmann
Jose Martinez
Beatriz Tijero
Koldo Berganzo
Horacio Kaufmann
Dysautonomia Foundation · USHospital de Cruces · ESNew York University · US

Funding

Training CoreU54NS065736 · NINDS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI FREEMAN, ROY · 2009 to 2018
$11.6M
NINDS NIH HHS U54 NS065736
6 · The paper itself

Abstract

Orthostatic hypotension (OH) is frequent in patients with Parkinson's disease (PD) and can occur with or without symptoms. Pharmacological treatments are effective, but often exacerbate supine hypertension. Guidelines exist for the diagnosis, but not for the treatment of OH. We examined the relationship between blood pressure (BP) and symptoms in a cohort of PD patients with the goal of identifying a hemodynamic target to guide treatment. We measured BP supine and upright (tilt or active standing) and identified the presence or absence of symptomatic OH by using a validated patient-reported outcome questionnaire in 210 patients with PD. We evaluated the usefulness of the 20/10 and 30/15 mmHg diagnostic criteria (systolic/diastolic) to identify symptomatic OH. Fifty percent of the PD patient cohort met criteria for the 20/10 fall and 30% for the 30/15 BP fall. Among the patients who met either OH criteria, the percentage of those with symptoms was small (33% of those with 20/10 and 44% of those with 30/15 mmHg; 16% and 13%, respectively, overall). Symptomatic OH was associated with an upright mean BP below 75 mmHg. A mean standing BP <75 mmHg had a sensitivity of 97% and a specificity of 98% for detecting symptomatic OH. Although the prevalence of OH in PD is high, not all patients have symptoms of organ hypoperfusion. A mean standing BP below 75 mmHg appears to be a useful benchmark when deciding whether the benefits of initiating pharmacological treatment of OH outweigh the risks of exacerbating supine hypertension.

Indexed as

AgedAge FactorsAntiparkinson AgentsBlood PressureEuropeFemaleHumansHypotension, OrthostaticLevodopaMaleMiddle AgedParkinson DiseaseProspective StudiesSensitivity and SpecificitySeverity of Illness IndexSurveys and QuestionnairesAntiparkinson AgentsLevodopaautonomic failureconsensus criteriadysautonomiamean blood pressurestanding blood pressuresupine hypertension

Identifiers

PMID25678194
PMCPMC4397106
OpenAlexW1843188283

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.