To investigate the characteristics of hemodynamics and cardiovascular and cerebrovascular disease and its high-risk factors in patients with Parkinson’s disease (PD) with orthostatic hypotension (OH) and supine hypertension (SH) and examine its effects on motor and non-motor symptoms. Methods: A total of 198 PD-OH patients were enrolled. Of these, 123 patients experienced SH (SH group) and 75 did not (non-SH group). Patients’clinical information, laboratory results, and comprehensive set of clinical features including both motor and non-motor symptoms were recorded. The lying to standing blood pressure (BP) test and acute levodopa challenge test were administered. We compared demographics and clinical features between the 2 groups, including cardiovascular and cerebrovascular disease and its high-risk factors as well as pre- and post-drug blood pressure and test scores. Results: The incidence of coexisting SH and OH in PD patients was 62.1%. There were no significant differences in age, sex, disease course, or levodopa equivalent dose between the 2 groups. Homocysteine was slightly higher in the SH group compared with the non-SH group (P<0.05), and there were no significant differences in the remaining high-risk factors for cardiovascular and cerebrovascular disease (P>0.05). The SH group showed a higher motor function score and higher postural instability and gait difficulty on the MDS-UPDRS III (P<0.05). The SH group presented a greater decrease in systolic BP after the pre-drug lying to standing BP test and acute levodopa challenge test (P<0.05) but a lower incidence of clinically significant OH (P<0.05). The risk of clinically significant OH was 3 times higher in the non-SH group than in the SH group (OR=2.991, P=0.002). In cognitive assessments, the SH group had a lower score in memory recall and orientation on the MMSE and a lower total score, visuospatial and executive function score, and orientation score on the MoCA compared to the non-SH group (P<0.05). There was no significant difference in the incidence of cognitive impairment between the 2 groups (P>0.05). Conclusion: The incidence of combined OH and SH in PD patients was high. We did not find evidence that PD-OH with SH increases risk of cardiovascular and cerebrovascular disease; on the contrary, SH played a protective role against clinically significant OH. PD patients with combined OH and SH should beware the risk of falls and dementia.