Blood pressure problems are a common problem in patients with Parkinson’s disease and multiple system atrophy, with the latter usually manifesting more severely and appearing earlier, greatly affecting patients’ quality of life. The following is a summary of the characteristics of blood pressure fluctuations and countermeasures in these two types of patients, in the hope that they will be beneficial to patients. I, blood pressure fluctuation characteristics 1, postural hypotension: the so-called postural hypotension, refers to the standing blood pressure is lower than the lying blood pressure, systolic blood pressure decreased by > = 20mmHg or diastolic blood pressure decreased by > = 10mmHg. for patients with multi-system atrophy, the decline is generally > = 30mmHg or 15mmHg. postural hypotension is the most likely cause of the patient’s quality of life and mobility decline One of the most common causes of postural hypotension is dizziness in the standing position and heaviness in the neck and shoulders in mild cases, which can lead to syncope in severe cases and cause secondary injuries such as fractures. Some data show that about 40-60% of patients with Parkinson’s disease have postural blood pressure, but only 20% have symptoms. A much higher percentage of patients with multiple system atrophy have postural hypotension than in Parkinson’s disease, and most are symptomatic, with syncope common. The cause of the occurrence of postural hypotension is mainly related to the pathophysiological damage of the disease itself, but anti-Parkinsonian drugs have the potential to exacerbate this change. 2. Recumbent hypertension: In addition to postural hypotension, patients may also exhibit elevated blood pressure in the recumbent position, exceeding the upper limit of normal (140/90 mmHg) and even up to about 200 mmHg, becoming a hidden risk for cardiovascular events. 3. One-day blood pressure changes: postural hypotension is likely to appear in the morning and after meals, and hypertension is likely to appear when lying down, especially at night and in the early morning. 2, blood pressure adjustment countermeasures 1, postural hypotension: non-pharmacological treatment – for the improvement of postural hypotension is usually very effective and deserves attention. Specific measures include: (1) check all oral medications and discontinue medications with side effects of postural hypotension if possible; (2) pay attention to ensure the intake of water and salt, drinking 400-500ml of water early in the morning is very obvious, and the effect is rapid, and the effect can be maintained for 60-90 minutes; (3) avoid environments that may lead to fluid loss or vasodilation, such as hot baths, excessive ambient temperature, alcohol consumption, a single meal, or a single meal. (4) Use of compression stockings during the day; (5) Actions to increase blood return, such as abdominal compression, tensing the calves (tensing the feet), etc.; (6) To reduce the risk of falling, it is advisable to follow a slow, step-by-step movement from lying to sitting to standing when rising. The medications available include fludrocortisone acetate, midodrine, etc., which have limited effects and corresponding side effects and need to be taken under medical supervision. Midodrine is relatively commonly used, and the appropriate time to take it is early in the morning before waking up and before lunch, and avoid taking it four hours before bedtime. Chinese medicine for postural hypotension often has a good adjunctive treatment effect. 2, recumbent hypertension: non-pharmacological treatment – avoid drinking water and taking blood pressure-raising drugs before bedtime; take off elastic stockings at rest; rest in a high head position and avoid lying down as much as possible. Drug treatment – use short-acting antihypertensive drugs, such as nifedipine (non-controlled-release tablets or extended-release tablets), nimodipine, etc., if necessary. 3. One-day blood pressure adjustment: The following chart gives examples of blood pressure management countermeasures at different times of the day for reference. The pathogenesis and pathophysiological changes of Parkinson’s disease and multisystem atrophy are complex, and changes in blood pressure are only part of the patient’s disease manifestations. Although adjusting blood pressure does not change the entire picture of the disease, it is effective in improving symptoms, and its role in improving patients’ quality of life should not be underestimated. The above detailed blood pressure management also fully reflects the particular need for individualized treatment of these two diseases.