Neurogenic Orthostatic Hypotension: An Underrecognized Complication of Parkinson Disease

J Neurosci Nurs. 2020 Oct;52(5):230-233. doi: 10.1097/JNN.0000000000000528.


Background: Neurogenic orthostatic hypotension (nOH) is a common source of disability but is an often untreated nonmotor symptom of Parkinson disease. The key manifestations of nOH include lightheadedness, dizziness, weakness, and fatigue when standing and engaging in activities in the upright position and result in falls, impaired activities of living, decreased quality of life, and short-term cognitive impairment. Early diagnosis and treatment of nOH are necessary to mitigate its adverse effects and reduce nOH-related symptom burden.

Case study: The management of nOH is illustrated through a case study.

Management considerations: Alerting providers about the impact and treatment of nOH, accurate measurement of orthostatic blood pressure, and educating patients and caregivers about nonpharmacological treatment options are important strategies to manage nOH. The goal of nOH treatment is to mitigate symptoms and improve the patient's quality of life.

Conclusions: Nurses can play a crucial role in the recognition and management of nOH. Nurses who are educated about nOH are well suited to partner with care providers to treat disabling motor and nonmotor symptoms of Parkinson disease.

Publication types

  • Case Reports

MeSH terms

  • Accidental Falls
  • Aged
  • Caregivers / education*
  • Cognitive Dysfunction
  • Dizziness / etiology
  • Droxidopa / therapeutic use
  • Humans
  • Hypotension, Orthostatic* / diagnosis
  • Hypotension, Orthostatic* / drug therapy
  • Hypotension, Orthostatic* / etiology
  • Male
  • Neuroscience Nursing
  • Parkinson Disease / complications*
  • Patient Education as Topic*
  • Quality of Life*


  • Droxidopa