Autonomic Dysfunction/Erratic BP Numbers

Posted by ablema1 @ablema1, Mar 6, 2022

My sister has erratic BP numbers. After she takes her PD medicines her BP drops to 66/41 or thereabouts. We went to the ER and after undergoing ECG , blood work which results came back normal she was discharged. Before discharge ER took blood pressure again and it read 191/78, pulse 68. Nurse said not to worry, go home and rest and take your BP meds. Since then her BP numbers has been erratic. Going low in the 92/49 or thereabouts after taking PD medications and then in 2 hours it shoots high again in the 176/80 or thereabout. PCP told her to log her BP numbers one hour before taking PD meds and one hour after taking it. She takes PD medications at 7:00 am , 12 noon, 5:00pm and at 10:00 pm : Her PD meds are Carbidopa 25 mg (2 tablets and 1/2) taken 3 times daily, one tablet each of Carbidopa 50 mg, 200 mg Levodopa and one half tablet of .05 Rasagiline at bedtime. Her BP meds are Atenolol 25 mg taken at 9:30 am and Losartan 25 mg taken at 2:00 pm and Simvastatin 10 mg taken after dinner.
Has anyone experienced this erratic BP. numbers. Would appreciate your input.
Her PCP scheduled her for ambulatory 24 hour BP monitor but Kaiser has only one monitor so she has to wait until the 3.16.22 when unit is available.

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healthsurrogate | @healthsurrogate | Mar 7, 2022

My brother experienced similar episodes and was sent to the ER multiple times dues to unresponsiveness. Extensive testing was done each time and everything was within normal limits. His neurologist has slowly decreased his carbidopa-levadopa doses and his cardiologist started him in Northera and with each ER visit has increased his dose. His episodes occur infrequently now but Northera dose is maxed out and the insurance company requires an exception for dose exceeding quantity limits. It’s a constant struggle between physicians, staff at the assisted living memory care and the insurance company.

ablema1 | @ablema1 | Mar 7, 2022

Thanks much. This is very helpful. Found a study published by NIH but don't know if this is relevant:
[Clonazepam in the treatment of labile arterial hypertension in the elderly]

[Article in Russian]
K V Dmitriev, V I Fedorova, A V Nedostup
PMID: 11417185
There is English translation.