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

Qiu, Chengxuan; Hu, Gang; Kivipelto, Miia; Laatikainen, Tiina; Antikaínen, Riitta; Fratiglioni, Laura; Jousilahti, Pekka; Tuomilehto, Jaakko

doi:10.1161/hypertensionaha.111.171249

Cited by 126 publications

(105 citation statements)

References 31 publications

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“…37 The biological mechanisms underlying such sex specificity remain unclear. Interestingly, several cardiovascular risk factors, such as hypercholesterolemia 38 and hypertension, 39 have been reported to be associated with increased risk of PD in women but not in men. This could play a part in the observed sex difference in the urate-PD relationship because higher urate concentrations are associated with these factors, which in turn might offset the potential neuroprotective effects of urate.…”

Section: Resultsmentioning

confidence: 99%

Prospective study of plasma urate and risk of Parkinson disease in men and women

et al. 2016

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Objective: To examine whether higher plasma urate concentrations are associated with a lower risk of developing Parkinson disease (PD) and whether there is a sex difference in the potential urate-PD relationship. Methods:We conducted a nested case-control study based on 90,214 participants of 3 ongoing US cohorts. We identified 388 new PD cases (202 men and 186 women) since blood collection, which were then matched to 1,267 controls. PD cases were confirmed by medical record review. Conditional logistic regression estimated relative risks (RRs) and 95% confidence intervals (95% CIs), after adjustment for age, smoking, caffeine intake, plasma concentrations of cholesterol and ferritin, and other covariates. We also conducted a meta-analysis to combine our study with 3 previously published prospective studies on urate and PD risk. Results:In the present nested case-control study, the multivariate-adjusted RRs of PD comparing extreme quartiles of urate were 0.63 (95% CI 0.35, 1.10; p trend 5 0.049) in men and 1.04 (95% CI 0.61, 1.78; p trend 5 0.44) in women (p heterogeneity 5 0.001). In the meta-analysis, the pooled RRs comparing 2 extreme quartiles of urate were 0.63 (95% CI 0.42, 0.95) in men and 0.89 (95% CI 0.57, 1.40) in women. Conclusion:We observed that men, but not women, with higher urate concentrations had a lower future risk of developing PD, suggesting that urate could be protective against PD risk or could slow disease progression during the preclinical stage of disease. Urate is a potent antioxidant and contributes to approximately 60% of the free radical scavenging activity in human serum.1,2 Serum urate concentrations in humans and apes are many-fold higher than those in other mammals as a consequence of evolutionary urate oxidase gene mutations.1 Results from in vitro and in vivo experimental studies suggest that urate could be a potential neuroprotective agent via its capacity to modify the cerebral damage induced by reactive nitrogen and oxidative species.2,3 In most, 4-8 but not all, 9 prospective observational studies in humans, higher concentrations of plasma urate were associated with a lower risk of developing Parkinson disease (PD). Further, patients with PD with higher urate levels have been found to have a slower disease progression relative to those with lower urate concentrations. 10,11 However, significant associations of higher urate levels with lower PD risk and slower progression were observed only in men. [4][5][6][7][8][9] Studies relating blood urate levels to PD risk were limited by their small sample sizes (PD case number , 160 in all studies) and underrepresentation of women. Therefore, it remains unclear whether this sex difference reflects a true difference in underlying biology or is due to lack of statistical power because women generally have lower urate concentration and lower PD incidence compared with men. Further, only one previous study 7 controlled for plasma ferritin and cholesterol levels, which have been found to be

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Section: Resultsmentioning

confidence: 99%

Prospective study of plasma urate and risk of Parkinson disease in men and women

et al. 2016

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“…Some studies [14,16,21,22] founded hypertension could reduce the risk of PD. However, some studies [23][24][25][26] founded hypertension could increase the risk of PD. Given the different effects, we carried out this meta-analysis to assess the relationship between hypertension and the risk of PD.…”

Section: Doi: 101159/000496977mentioning

confidence: 99%

Association between Hypertension and the Risk of Parkinson’s Disease: A Meta-Analysis of Analytical Studies

Chen

Zhang

et al. 2019

Neuroepidemiology

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Background: The results of analytical studies show that the association between hypertension and the risk of Parkinson’s disease (PD) remains controversial. Method: We searched studies related to the association between hypertension and the risk of PD. We pooled the ORs and risk ratios (RRs) with 95% confidence interval (CI) with random effects model and conducted meta-regression to explore potential sources of heterogeneity. Publication bias was estimated by Egger’s test and the funnel plot. Results: Twenty-six articles containing 27 studies were included, involving 9 cohort studies and 18 case-control studies. In cohort studies, compared with the non-hypertension participants, the pooled RR for the risk of PD was 1.70 (95% CI 1.60–1.80) for the patients with hypertension. In case-control studies, compared with the non-hypertension participants, the pooled OR for the risk of PD was 0.85 (95% CI 0.78–0.92) for the patients with hypertension. There were no publication bias in cohort studies and case-control studies. Conclusion: Based on population-based cohort studies, this meta-analysis indicated that hypertension might increase the risk of PD. In view of both hypertension and PD having an association with aging, case-control studies, especially the studies based on hospital records, were not suitable for similar studies.

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“…3,4 Recent studies have suggested that PD is associated with certain vascular risk factors, such as diabetes 5,6 and hypertension. 7 Because these 2 conditions are also risk factors for AMI, these vascular comorbidities may confound the association between PD and AMI. One way of minimizing the potential confounding effects of comorbidities is to match various clinical characteristics between subjects with and without PD.…”

mentioning

confidence: 99%

Parkinson disease and risk of acute myocardial infarction: A population-based, propensity score–matched, longitudinal follow-up study

Liang

Huang

Pan

2015

American Heart Journal

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

Cited by 126 publications

References 31 publications

Prospective study of plasma urate and risk of Parkinson disease in men and women

Prospective study of plasma urate and risk of Parkinson disease in men and women

Association between Hypertension and the Risk of Parkinson’s Disease: A Meta-Analysis of Analytical Studies

Parkinson disease and risk of acute myocardial infarction: A population-based, propensity score–matched, longitudinal follow-up study

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