Use of antihypertensives and the risk of Parkinson disease
Use of antihypertensives and the risk of Parkinson disease
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DOI：
10.1212/01.wnl.0000303818.38960.44
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发表时间：
2008-04-15
期刊：
影响因子：
9.9
通讯作者：
Meier, Christoph R.
中科院分区：
文献类型：
--
作者：
Becker, Claudia;Jick, Susan S.;Meier, Christoph R.
背景：最近的研究表明血管紧张素转换酶（ACE）抑制剂和钙通道阻滞剂可能具有神经保护作用。关于血管紧张素II（AT II）拮抗剂或β受体阻滞剂的神经保护作用知之甚少。目的：探讨降压药物使用与首次诊断帕金森病（PD）风险之间的关系。方法：这是一项英国全科医学研究数据库中的病例对照分析。1994年至2005年期间，病例年龄≥ 40岁，诊断为PD。我们在数据库中将一个对照组与每个PD病例的年龄、性别、一般实践、索引日期和既往病史持续时间相匹配。我们通过时间和暴露持续时间来评估抗高血压药物的使用。我们使用条件Logistic回归计算OR，调整体重指数，吸烟，各种心血管，代谢和精神疾病和dementia.Results：我们确定了3,637例首次诊断为特发性PD和相同数量的匹配对照。与不使用降压药相比，目前使用≥ 30张处方的调整OR为1.08（95% CI 0.85 - 1.37），对于ACE抑制剂，0.91（95% CI 0.41 - 2.00）AT II拮抗剂，1.16（95% CI 0.95 - 1.41），β-受体阻滞剂为0.77（95% CI 0.63 - 0.95）。结论：目前长期使用钙通道阻滞剂与帕金森病诊断风险显著降低相关，而血管紧张素转换酶抑制剂或β受体阻滞剂使用者的风险没有实质性改变，血管紧张素II拮抗剂使用者的风险统计学精确度较低。
Background: Recent studies related angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers to possible neuroprotective effects. Little is known about neuroprotection of angiotensin II (AT II) antagonists or beta-blockers.Objective: To explore the association between antihypertensive drug use and the risk of developing a first-time diagnosis of Parkinson disease (PD).Methods: This was a case-control analysis within the UK-based General Practice Research Database. Cases were >= 40 years of age with an incident PD diagnosis between 1994 and 2005. We matched one control to each PD case on age, sex, general practice, index date, and duration of previous history in the database. We assessed antihypertensive drug use by timing and by exposure duration. We calculated ORs using conditional logistic regression, adjusted for body mass index, smoking, and various cardiovascular, metabolic, and psychiatric diseases and dementia.Results: We identified 3,637 cases with a first-time diagnosis of idiopathic PD and an equal number of matched controls. As compared to nonuse of antihypertensive drugs, the adjusted OR for current use of >= 30 prescriptions was 1.08 (95% CI 0.85 to 1.37) for ACE inhibitors, 0.91 (95% CI 0.41 to 2.00) for AT II antagonists, 1.16 (95% CI 0.95 to 1.41) for beta-blockers, and 0.77 (95% CI 0.63 to 0.95) for calcium channel blockers.Conclusions: Current long-term use of calcium channel blockers was associated with a significantly reduced risk of a Parkinson disease diagnosis, while the risk was not materially altered for users of angiotensin converting enzyme inhibitors or beta-blockers and, with less statistical precision, for users of angiotensin II antagonists.