ArticleEuropean journal of neurology2024
Levodopa-induced orthostatic hypotension in parkinsonism: A red flag of autonomic failure.
Article in European journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Effects of levodopa/carbidopa intestinal gel infusion on autonomic symptoms in advanced Parkinson's disease: a systematic review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Pooled it
- Prevalence and incidence of orthostatic hypotension in patients with Parkinson's disease: an updated systematic review and meta-analysis.Frontiers in neurologyPooled it
- Effects of 6 months of endurance exercise on motor function, exercise capacity, and autonomic function based on presence of autonomic dysfunction in individuals with early Parkinson's disease.Journal of Parkinson's disease · 2025Trial
- Effect of levodopa on postural blood pressure changes in Parkinson disease: a randomized crossover study.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Trial
- Orthostatic hypotension and acute cognitive dysfunction in Parkinson's disease: insights from functional near-infrared spectroscopy.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026Article
- Cardiovascular pharmacology of dopaminergic agents in humans: a review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026Review
- How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- 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 · 2026Article
- Association of blood pressure variability with white matter hyperintensities and nigrostriatal dopaminergic deficits in drug-naïve Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Article
- The Effect of Dopaminergic Therapies in Parkinson's Disease on Non-Motor Symptoms.International journal of molecular sciences · 2025Review
- Exploring the relationship between orthostatic hypotension and gait in people with Parkinson's disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Article
- Subthalamic deep brain stimulation does not impact on cardiovascular and sudomotor functions assessed by head-up tilt test and sudoscan.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Approach to Cardiovascular Autonomic Dysfunction in Patients with Synucleinopathies.Movement disorders clinical practice · 2025Review
- Acute Pharmacodynamic Effects of Oral Levodopa on Blood Pressure in Parkinson's Disease.Pharmacotherapy · 2025Article
- Peripheral autonomic failure is associated with more severe postprandial hypotension compared to central autonomic failure.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Article
- Risk assessment of the top 50 drugs associated with drug-induced orthostatic hypotension: a disproportionality analysis of the FAERS and JADER databases.Scientific reports · 2025Article
- Neurogenic Orthostatic Hypotension in Parkinson Disease-A Narrative Review of Diagnosis and Management.Journal of clinical medicine · 2025Review
- Orthostatic hypotension in Parkinson's disease: therapeutic considerations.Therapeutic advances in neurological disorders · 2025Review
- Wearable multimodal sensing for quantifying the cardiovascular autonomic effects of levodopa in parkinsonism.Frontiers in network physiology · 2025Article
- Comment to the article titled: sympathetic dysfunction as an early indicator of autonomic involvement in Parkinson's disease.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeLevodopa (LD) is the main treatment for parkinsonism, but its use may be limited by a potential hypotensive effect.
methodsWe evaluated the cardiovascular effect of LD performing head-up tilt test (HUTT) before and 60 min after 100/25 mg LD/dopa-decarboxylase inhibitor (pre-LD vs. post-LD HUTT) in 164 patients with parkinsonism on chronic LD treatment. Features predictive of LD-induced orthostatic hypotension (OH) were assessed by logistic regression analysis.
resultsBasal supine blood pressure (BP) and heart rate (HR) decreased after LD. During post-LD HUTT, BP drop and HR increase were significantly greater than at pre-LD HUTT. Thirty-eight percent of patients had OH at post-LD HUTT compared to 22% of patients presenting OH at pre-LD HUTT (p < 0.001). Risk factors for LD-induced/worsened OH were pre-LD OH (odds ratio [OR] = 36, 95% confidence interval [CI] = 10-131), absence of overshoot at Valsalva maneuver (OR = 9, 95% CI = 4-20), and pathological Valsalva ratio (OR = 6, 95% CI = 2-15).
conclusionsLD administration caused/worsened hypotension in both supine and orthostatic conditions. Patients with cardiovascular autonomic failure had a higher risk of developing LD-induced OH. In clinical practice, LD-induced OH could represent a red flag for cardiovascular autonomic failure.
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Registered trials
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