Parkinson’s disease (PD) is primarily known as a neurological disorder affecting movement, but it also has significant effects on the heart and circulation. The disease impacts the autonomic nervous system, which controls involuntary bodily functions including heart rate, blood pressure, and blood vessel regulation. This disruption can lead to a range of cardiovascular problems that complicate the overall health of people with Parkinson’s.
One of the most common cardiovascular issues in Parkinson’s is **autonomic dysfunction**, where the nerves that regulate heart and blood vessel activity do not work properly. This can cause **orthostatic hypotension**, a condition where blood pressure drops sharply when a person stands up from sitting or lying down. This sudden drop can cause dizziness, fainting, and falls, which are already a major concern in Parkinson’s due to balance and mobility problems. Orthostatic hypotension affects about 30% of people with Parkinson’s and significantly worsens their quality of life by increasing the risk of injury and limiting daily activities.
The autonomic nervous system imbalance in Parkinson’s also affects **heart rate variability (HRV)**, which is the natural variation in time between heartbeats. Normally, HRV reflects a healthy balance between the sympathetic nervous system (which speeds up the heart) and the parasympathetic nervous system (which slows it down). In Parkinson’s, this balance is disturbed, often showing reduced HRV. Low HRV is linked to a higher risk of heart attacks, stroke, and overall mortality. This means that people with Parkinson’s are more vulnerable to cardiovascular events, partly because their heart cannot respond flexibly to changing demands.
Parkinson’s disease also increases the risk of serious cardiovascular conditions such as **myocardial infarction (heart attack)**, **ischemic stroke**, and **congestive heart failure**. Studies have shown that individuals with Parkinson’s have a higher likelihood of experiencing these events compared to those without the disease. The reasons are multifactorial: autonomic dysfunction, reduced physical activity, metabolic changes, and possibly shared underlying pathological processes that affect both the brain and heart.
Another factor linking Parkinson’s to heart and circulation problems is **metabolic syndrome**, a cluster of conditions including high blood pressure, abdominal obesity, insulin resistance, and abnormal cholesterol levels. Metabolic syndrome is common in the general population and has been found to increase the risk of developing Parkinson’s disease. It also independently raises the risk of cardiovascular disease. When metabolic syndrome coexists with Parkinson’s, it can exacerbate heart and circulation problems, making management more challenging.
The **stress response system**, particularly the hypothalamic-pituitary-adrenal (HPA) axis, also plays a role. Parkinson’s and aging can dysregulate this system, leading to sustained high levels of cortisol, a stress hormone. Elevated cortisol contributes to hypertension (high blood pressure), oxidative stress, and damage to blood vessels, all of which worsen cardiovascular health. Additionally, surges of catecholamines (stress-related hormones like adrenaline) from the adrenal glands can further strain the heart, especially after neurological insults.
In Parkinson’s, the **communication between the brain and heart** is disrupted. Normally, the brain regulates heart function through complex feedback loops involving the autonomic nervous system. Neurodegeneration in Parkinson’s affects these pathways, leading to impaired control of heart rate and blood pressure. This can cause not only orthostatic hypotension but also episodes of high blood pressure or irregular heart rhythms.
The consequences of these cardiovascular effects are serious. Reduced blood flow due to low blood pressure or heart dysfunction can impair oxygen delivery to vital organs, including the brain. This may contribute to cognitive decline and increase the risk of dementia, which is common in advanced Parkinson’s. Poor circulation also worsens fatigue and physical frailty, limiting mobility and independence.
Managing heart and circulation problems in Parkinson’s requires careful attention. Treatments may include medications to raise blood pressure when standing, lifestyle changes t
