Case-control study of hypertension and Parkinson’s disease

Abstract

We evaluate the association of hypertension with PD in an Asian population and performed a meta-analysis on similar studies to address the effect of hypertension on PD risk. A matched case-control study involving 1342 Chinese subjects (671 PD and 671 age and gender-matched controls (with a mean age of 63.9 ± 9.7 and 63.5 ± 9.8 years, and identical proportion of gender distribution) was conducted. Hypertension increases PD risk by 1.9 times [OR 1.86 (1.46–2.38)]. The literature search identified 618 studies initially; however, only three matched case-control studies (all in Caucasians) met the inclusion criteria for meta-analysis. Overall analysis showed that hypertension decreases PD risk by 0.2 times [OR 0.80 (0.66–0.96)]. Hypertension increases PD risk by 1.9 times in our Asian population. However, a meta-analysis comprising of Caucasian populations showed a protective effect of hypertension suggesting that ethnic differences or other genetic or environmental factors may contribute to the divergent observation. Early diagnosis and treatment of hypertension may potentially reduce the risk of PD, at least in our population.

Intestine-derived α-synuclein initiates and aggravates pathogenesis of Parkinson’s disease in Drosophila

“…Parkinson’s disease (PD) is the second most common debilitating neurodegenerative disorder, with prevalence of 1% in individuals over 60 years old worldwide [ 1 , 2 ]. PD is clinically characterized by motor deficits, including bradyskinesia, resting tremor, muscle rigidity, and postural instability, and causes significant morbidity as well as decreases in psychosocial health and physical quality of life [ 3 , 4 ]. A key pathological feature of PD is the selective loss of dopaminergic (DA) neurons in the substantia nigra pars compacta.…”

Neurodegenerative diseases and blood pressure variability: A comprehensive review from HOPE Asia

“… 90 , 91 , 92 A meta‐analysis of case‐control studies by Ng and coworkers in Asian populations, showed that hypertension increases the risk of PD by 1.9 times, but there are genetic and environmental factors that may influence it because, in the Caucasian population, hypertension was found to be a protective factor of PD. 16 Autonomic dysfunction that occurs in PD is caused by a neuropathological process by abnormal deposits of α‐synuclein forming neuronal inclusions of Lewy body that are found in autonomic neurons in peripheral nerves and also in CNS, particularly in substantia nigra pars compacta (SNpc) and locus coeruleus (LC) causing neurodegeneration. 93 , 94 Shen and coworkers found that the BPV in the advanced stage of the PD group was significantly higher than in the early stage of the PD group and the normal group, also the differences between these groups in both BPV and circadian BP rhythm measurements were statistically significant, although there was no significant difference between the groups of PD with predominantly tremor or non‐tremor; This can allow BPV examination to detect the progression of a stage of PD or various abnormalities related to BP before other symptoms develop.…”

“… 118 Another meta‐analysis by Hou and coworkers and Ng and coworkers suggests that hypertension might increase the risk of PD, specifically in the Asian population. 8 , 16 Those studies highlight the importance of early diagnosis and treatment of hypertension, which will be essential and critical for those with preclinical neurodegenerative disease. 8 , 118 The blood pressure target must also be personalized, especially in frail and very old patients.…”

“… 13 , 14 , 15 It strongly correlates with brain aging, increasing AD and PD risk, especially in the Asian population. 7 , 16 It is also known that each continent has its risk factor differences regarding blood pressure variability (BPV), which affects the susceptibility toward neurodegenerative diseases, including in Asia. 7 This paper will discuss further the significance of brain aging and BPV, and its impact on neurodegenerative diseases in Asia.…”

“…Controlling neurodegenerative diseases’ risk factors, including hypertension, is critical as it is a significant risk factor for target organ damage, including the brain 13–15 . It strongly correlates with brain aging, increasing AD and PD risk, especially in the Asian population 7,16 . It is also known that each continent has its risk factor differences regarding blood pressure variability (BPV), which affects the susceptibility toward neurodegenerative diseases, including in Asia 7 .…”