高血压、抗高血压药物的使用与亨廷顿病发病时间的延迟。

Hypertension, Antihypertensive Use and the Delayed-Onset of Huntington's Disease.

机构信息

Cardiff University Brain Research Imaging Centre (CUBRIC), School of Physics and Astronomy, Maindy Road, Cardiff University, Cardiff, Wales, UK.

Neuroscience and Mental Health Research Institute and Brain Research and Intracerebral Neurotherapeutic (BRAIN) unit, School of Medicine, Cardiff University, Cardiff, Wales, UK.

出版信息

Mov Disord. 2020 Jun;35(6):937-946. doi: 10.1002/mds.27976. Epub 2020 Feb 4.

DOI:10.1002/mds.27976

PMID:32017180

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7317197/

Abstract

BACKGROUND

Hypertension is a modifiable cardiovascular risk factor implicated in neurodegeneration and dementia risk. In Huntington's disease, a monogenic neurodegenerative disease, autonomic and vascular abnormalities have been reported. This study's objective was to examine the relationship between hypertension and disease severity and progression in Huntington's disease.

METHODS

Using longitudinal data from the largest worldwide observational study of Huntington's disease (n = 14,534), we assessed the relationship between hypertension, disease severity, and rate of clinical progression in Huntington's disease mutation carriers. Propensity score matching was used to statistically match normotensive and hypertensive participants for age, sex, body mass index, ethnicity, and CAG length.

RESULTS

Huntington's disease patients had a lower prevalence of hypertension compared with age-matched gene-negative controls. Huntington's disease patients with hypertension had worse cognitive function, a higher depression score, and more marked motor progression over time compared with Huntington's disease patients without hypertension. However, hypertensive patients taking antihypertensive medication had less motor, cognitive, and functional impairment than Huntington's disease patients with untreated hypertension and a later age of clinical onset compared with untreated hypertensive patients and normotensive individuals with Huntington's disease.

CONCLUSIONS

We report the novel finding that hypertension and antihypertensive medication use are associated with altered disease severity, progression, and clinical onset in patients with Huntington's disease. These findings have implications for the management of hypertension in Huntington's disease and suggest that prospective studies of the symptomatic or disease-modifying potential of antihypertensives in neurodegenerative diseases are warranted. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

摘要

背景

高血压是一种可改变的心血管风险因素，与神经退行性变和痴呆风险有关。在亨廷顿病中，已报道自主和血管异常。本研究的目的是检查高血压与亨廷顿病严重程度和进展的关系。

方法

使用亨廷顿病最大的全球观察性研究的纵向数据（n=14534），我们评估了高血压、疾病严重程度和亨廷顿病突变携带者临床进展率之间的关系。采用倾向评分匹配，根据年龄、性别、体重指数、种族和 CAG 长度对正常血压和高血压参与者进行统计学匹配。

结果

与年龄匹配的基因阴性对照相比，亨廷顿病患者高血压的患病率较低。与无高血压的亨廷顿病患者相比，高血压的亨廷顿病患者认知功能更差，抑郁评分更高，且随着时间的推移运动进展更明显。然而，服用降压药物的高血压患者的运动、认知和功能障碍比未经治疗的高血压亨廷顿病患者少，且与未经治疗的高血压患者和有亨廷顿病的正常血压个体相比，其发病年龄较晚。