Parkinson’s and fluctuating blood pressure

Hello @2022hibiscus and welcome to Connect. While I've never experienced this problem with fluctuating blood pressure, I do know of PD patients who have had this.

Are you familiar with the Davis Phinney Foundation? It is designed for the education and research about Parkinson's. I did find an article on their website which gives several non-medical ways to help manage this problem.
Here is the link to the article, Manage Neurogenic Orthostatic Blood Pressure https://davisphinneyfoundation.org/steps-to-manage-noh/.

If you are comfortable sharing more, I am wondering how long you have had PD, and what PD medications you are currently taking? Have you had this blood pressure problem for a long time?

I don’t have Parkinson’s Disease but I am afflicted with WPW which stands for Wolff, Parkinson, White Syndrome. You will recognize the middle person, yes, the same doctor. My symptoms are many and associated with WPW, some very similar to yours. My WPW is directly linked to my heart, especially the SA node(the body’s natural pacemaker) and the AV node, (the commanding general) that tells the heart to beat. When the SA node sends the signal (electrical pulse) the AV node tells the right ventricle to squeeze, forcing blood into your lungs. Because of a heart birth defect, a short circuit was accidentally made from the SA node to the AV node and the pulse just keeps going around and around forcing the heart to beat faster and faster, as many as 197bpm. Now, I’m telling you all this because my bp spikes as high as 211/113, that’s stroke area, for which I’ve had a mini stroke. Then my bp began to tank on other occasions 50/41 with a heart rate of 42bpm. I don’t know of your pharmacy give you side affect sheet when getting your medicine but mine does. Because of my WPW, I have to be extremely careful of rare side effects, since 1 pill almost killed me my bp shot so high. With the help of my pharmacist and the company who manufactured the drug, they discovered I had a rare side, I wasn’t highly allergic to the medicine itself but the “coating” that holds the pill together. So I’d suggest you go to your pharmacist and see what they think about your symptoms. Did you know a pharmacist has to go to college longer than a doctor does. That’s why any medication problems I may have, I ask their advice before I talk to my doctor about a side effect. Good luck.

My brother has Parkinson’s and was having the same problem and now he’s on droxidopa (Northera) 300 mg three times a day. Had difficulty with coverage by new prescription drug plan so we tried midodrine which had no effect. Finally got droxidopa authorized and his blood pressures have stabilized.

His cardiologist and neurologist said orthostatic hypotension is common in PD but the low BPs occurred even when he was passively sitting upright in a chair. It was recognized due to his lack of response when they addressed him. His BP was the only abnormality and by the time he got to the ER he was responsive and back to his usual state.