Antihypertensive Agents and Risk of Parkinson’s Disease, Essential Tremor and Dementia: A Population-Based Prospective Study (NEDICES)

Abstract

Background: Recent interest in antihypertensive agents, especially calcium channel blockers, has been sparked by the notion that these medications may be neuroprotective. A modest literature, with mixed results, has examined whether these medications might lower the odds or risk of Parkinson’s disease (PD) or dementia. There are no data for essential tremor (ET). Objective: To examine the association between antihypertensive use (defined broadly and by individual subclasses) and ET, PD and dementia. For each disorder, we used cross-sectional data (association with prevalent disease) and prospective data (association with incident disease). Methods: Prospective population-based study in Spain enrolling 5,278 participants at baseline. Results: Use of antihypertensive medications (aside from β-blockers) was similar in prevalent ET cases and controls. Baseline use of antihypertensive agents was not associated with reduced risk of incident ET. Antihypertensive medication use was not associated with prevalent or incident PD. Calcium channel blocker use was marginally reduced in prevalent dementia cases (OR_adjusted = 0.63, p = 0.06) but was not associated with reduced risk of incident dementia (RR_adjusted = 1.02, p = 0.95). Conclusions: We did not find evidence of a protective effect of antihypertensive medications in these three neurodegenerative disorders.

Selective Positive Modulator of Calcium-Activated Potassium Channels Exerts Beneficial Effects in a Mouse Model of Spinocerebellar Ataxia Type 2

“…The proposed explanation of NS13001 or CyPPA ability to protect PCs in SCA2 mice is consistent with studies in Parkinson's disease (PD) field, where it was demonstrated that reducing voltage-dependent Ca 2+ influx during pacemaker firing of substantia nigra (SNc) neurons leads to neuroprotection in models of PD (Chan et al, 2009, 2010; Surmeier, 2007; Surmeier et al, 2010) and possibly in PD patients (Becker et al, 2008; Ritz et al, 2010) (but see (Louis et al, 2009; Simon et al, 2010)). In case of studies in PD models, the Ca 2+ influx in SNc neurons was reduced not by slowing down pacemaking activity of these cells but by pharmacological block of Ca V 1.3 voltage-gated Ca 2+ channels which mediate most of Ca 2+ influx in these cells during spontaneous activity (Chan et al, 2010).…”

Association of Blood Pressure and Hypertension With the Risk of Parkinson Disease

“…6,20 We found no association between the use of antihypertensive agents and the risk of PD, which is in line with previous reports from case-control and population-based prospective studies. 5,7,21 In addition, in women, untreated hypertension or treated but not well-controlled hypertension is associated with an increased risk of PD. Unfortunately, we are not able to conclude whether controlling BP at an optimal target level will diminish the increased risk of PD associated with elevated BP because of the small number of subjects in this group.…”

Association between Essential Tremor and Other Neurodegenerative Diseases: What Is the Epidemiological Evidence

“…These include its association with advancing age, its insidious onset, its progressive clinical course, as well as the presence of neuronal loss on postmortem examination. Hence, it is likely that ET itself is neurodegenerative [15,17,95] . There is a sizable literature demonstrating that neurodegenerative diseases may be associated with one another, with the notion being that the development of one such disorder is a marker of a biological propensity/vulnerability for the development of others.…”