Antihypertensive agents and risk of Parkinson's disease: A nationwide cohort study
Journal
PLoS ONE
Journal Volume
9
Journal Issue
6
Date Issued
2014
Author(s)
Abstract
Background and Purpose: Hypertension has been associated with Parkinson's disease (PD), but data on antihypertensive drugs and PD are inconclusive. We aim to evaluate antihypertensive drugs for an association with PD in hypertensive patients. Methods: Hypertensive patients who were free of PD, dementia and stroke were recruited from 2005-2006 using Taiwan National Health Insurance Database. We examined the association between the use of calcium channel blockers (CCBs), angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) and the incidence of PD using beta-blockers as the reference. Cox regression model with time-varying medication use was applied. Results: Among 65,001 hypertensive patients with a mean follow-up period of 4.6 years, use of dihydropyridine CCBs, but not non-dihydropyridine CCBs, was associated with a reduced risk of PD (adjusted hazard ratio [aHR] = 0.71; 95% CI, 0.57-0.90). Additionally, use of central-acting CCBs, rather than peripheral-acting ones, was associated with a decreased risk of PD (aHR = .69 [55-0.87]. Further decreased association was observed for higher cumulative doses of felodipine (aHR = 0.54 [0.36-0.80]) and amlodipine (aHR = 0.60 [0.45-0.79]). There was no association between the use of ACEIs (aHR = 0.80 [0.64-1.00]) or ARBs (aHR = 0.86 [0.69-1.08]) with PD. A potentially decreased association was only found for higher cumulative use of ACEIs (HR = 0.52 [0.34-0.80]) and ARBs (HR = 0.52 [0.33-0.80]). Conclusions: Our study suggests centrally-acting dihydropyridine CCB use and high cumulative doses of ACEIs and ARBs may associate with a decreased incidence of PD in hypertensive patients. Further long-term follow-up studies are needed to confirm the potential beneficial effects of antihypertensive agents in PD. ? 2014 Lee et al.
SDGs
Other Subjects
amlodipine; angiotensin receptor antagonist; calcium channel blocking agent; diltiazem; dipeptidyl carboxypeptidase inhibitor; felodipine; lacidipine; lercanidipine; nifedipine; nitrendipine; verapamil; angiotensin receptor antagonist; antihypertensive agent; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; adult; aged; article; cohort analysis; controlled study; disease association; dose response; female; high risk patient; human; hypertension; incidence; major clinical study; male; Parkinson disease; risk assessment; risk reduction; Parkinson disease; proportional hazards model; risk; Taiwan; Aged; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Calcium Channel Blockers; Cohort Studies; Female; Humans; Male; Parkinson Disease; Proportional Hazards Models; Risk; Taiwan
Publisher
Public Library of Science
Type
journal article