Prevalence and Impact of Orthostatic Hypotension in Parkinson's Disease: A Systematic Review and Meta-Analysis

Objective: Parkinson’s disease (PD) is frequently associated with orthostatic hypotension (OH). Research on the prevalence of OH in PD and its effects on patients has produced inconsistent findings. Methods: A systematic review and meta-analysis were performed by searching for studies related to PD and OH in the PubMed, Web of Science, Embase, and Cochrane databases. Data were pooled as necessary to calculate the prevalence of OH in PD patients, along with odds ratios (OR), weighted mean differences (WMD), or standardized mean difference (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using the I²statistic. Results: The prevalence of OH in patients with PD was found to be 33.1% (95% CI, 29.3%-37%) in a pooled sample of 7,748 subjects. Patients with PD and OH were significantly older at the time of examination (WMD 2.92 years) and had a longer disease duration (WMD 0.71 years) compared to those without OH. There was no significant difference in the distribution of sex, or in the scores of Unified Parkinson's Disease Rating Scale (UPDRS) parts I and II, as well as the total scores among Parkinson's disease patients with or without OH. Additionally, PD patients with OH exhibited significantly higher UPDRS scores across part 3 section scores (SMD 0.41, 95% CI 0.23 to 0.59). Conclusion: The prevalence of OH in PD is 33.1%. Patients with PD and OH are generally older at examination, have a longer disease duration, and display more severe disease manifestations compared to those without OH.