ABSTRACT
The cardiovascular system is influenced by a variety of factors that include the autonomic nervous system. Through the arterial baroreceptor reflex, the sympathetic and parasympathetic components of the autonomic nervous system exert beat-by-beat control over the maintenance of blood pressure and both directly and indirectly influence the perfusion of various organs. In Parkinson’s disease and various parkinsonian syndromes, cardiovascular dysfunction may occur for a variety of reasons. Autonomic failure is an integral component of parkinsonian syndromes such as multiple system atrophy (MSA), where orthostatic (postural) hypotension is an important clue to underlying cardiovascular autonomic failure and in the recognition of this disorder.1 The majority of parkinsonian patients are over the age of 50, when the incidence of cardiovascular disorders increases regardless of associated disease. Many parkinsonian patients are on drugs (antiparkinsonian or for coincidental medical disorders) that may have cardiovascular side effects. Furthermore, with advancing years, there is impairment of autonomic function that may occur independently of the parkinsonian state.2
