Reduced Risk Factors for Vascular Disorders in Parkinson Disease Patients

Abstract

Background and Purpose-Sympathetic hyperactivity is a contributing cause of vascular disorders because it increases blood pressure, blood sugar, and blood lipids. Pervasive compromise of the central and peripheral autonomic nervous systems is common in idiopathic Parkinson disease (IPD) resulting in reduced sympathetic and parasympathetic function. We hypothesized that IPD was associated with reduced prevalence of cardiovascular disease risk factors as a result of reduced sympathetic activity. Methods-We performed a retrospective case-control study on 178 newly diagnosed consecutive IPD patients, and 533 age-(Ϯ3 years) and sex-matched controls with other neurological diseases seen over the same period at the same hospital. For each case and control the following were noted on admission: smoking, diabetes, hypertension, body mass index, serum glucose, plasma cholesterol, triglycerides and total lipid levels, and blood pressure. Results-Diabetes, history of smoking, high blood pressure, high blood glucose, high blood cholesterol, and triglycerides were significantly less frequent in IPD than controls. Conclusions-IDP is a natural model of impaired hypothalamic-pituitary-adrenal axis activity and generalized sympathetic denervation. We interpret the association of untreated IPD with reduced vascular diseases risk factors as attributable to reduced autonomic activity, suggesting that autonomic hyperactivity may be involved in the pathogenesis of vascular disorders.

Effect of heart rate on the risk of developing metabolic syndrome

“…The reduction in these risk factors is attributed to reduced autonomic activity, suggesting that autonomic hyperactivity may be involved in the pathogenesis of vascular disorders. 38 A previous study by our group suggested that women have higher heart rates than men in all age groups. 8 Accordingly, the threshold for tachycardia in women is higher than that for men.…”

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

“…Another found lower risk of PD associated with total serum cholesterol and total serum lipids in univariate but not in multivariate analyses [631]. However, for high serum triglycerides, the multivariate analyses showed lower PD risk (OR 0.49, 95% CI 0.27-0.89) [631]. A hospital-based case-control study, in which spouses of patients from a movement disorder clinic were used as controls, reported increased PD risk with lower serum low-density lipoprotein (LDL) cholesterol (OR for lowest category versus highest 2.6, 95% CI 1.1-6.0), but no significant association for total and high-density lipoprotein (HDL) cholesterol [638].…”

“…An early case-control study [127] reported higher frequency of hypertension among PD cases compared to controls, although no p value was provided. Six other case-control studies [132,142,303,358,409,466] found no association between selfreported hypertension and PD, one study found lower risk of PD associated with hypertension in univariate analyses, but when adjusting for smoking and other variables, the association did not persist [631]. Another case-control study reported increased PD risk associated with hypertension in women (OR 1.62, 95% CI 1.00-2.62) but not in men [540].…”

“…In sum, one study with insurance record PD diagnoses without validation [629] and one small case-control study [127] reported increased PD risk among patients with diabetes, but this association was not confirmed in five other well designed case-control studies [142,358,540,631,635]. Two large prospective studies reported increased PD risk associated with diabetes [632,633], one prospective study reported no association [634], whereas another reported lower risk of diabetes among PD cases [635].…”

“…Among the few studies that examined this relationship, one study found no association between self-reported hyperlipidemia and PD [142]. Another found lower risk of PD associated with total serum cholesterol and total serum lipids in univariate but not in multivariate analyses [631]. However, for high serum triglycerides, the multivariate analyses showed lower PD risk (OR 0.49, 95% CI 0.27-0.89) [631].…”