Tseng Yuan-Fu, Lin Hsiu-Chen, Chao Jane Chen-Jui, Hsu Chien-Yeh, Lin Hsiu-Li
Department of Neurology, Sijhih Cathay General Hospital, New Taipei City, Taiwan.
Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Laboratory Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
J Neurol Sci. 2021 May 15;424:117412. doi: 10.1016/j.jns.2021.117412. Epub 2021 Mar 24.
The use of dihydropyridine calcium channel blockers (DCCBs) was proposed to reduce the risk of Parkinson's disease (PD). This study aimed to evaluate the association between DCCB and its dose effect and the risk of PD in patients with newly diagnosed hypertension.
This population-based retrospective cohort study enrolled 107,207 patients with newly diagnosed hypertension, between 2001 and 2013, from Taiwan's National Health Insurance Research Database. Patients who had PD before hypertension or were taking antipsychotics for more than 30 days in the 6 months prior to the end of the observation period were excluded. A Cox proportional hazard model was used to estimate the risk of PD in different groups. The dose-related effects of DCCB on the risk of PD were evaluated according to the cumulative defined daily dose (DDD).
We observed 832 (1.2%) PD cases in patients treated with DCCB as compared to 950 (2.4%) PD cases in those not treated with DCCB, during a median follow-up duration of 8.3 years and 6.2 years, respectively. The risk of PD in the DCCB-treated group (hazard ratio [HR] = 0.50) was significantly lower than that in the group without DCCB treatment. DCCB reduced the risk of PD in a dose-dependent manner, with HRs ranging from 0.61 to 0.37 for DDDs of 90-180 to >720.
DCCB treatment was associated with a significantly reduced risk of PD in patients with newly diagnosed hypertension. Further clinical trials are needed to confirm the proposed neuroprotective effects of DCCB in PD.
有人提出使用二氢吡啶类钙通道阻滞剂（DCCB）可降低帕金森病（PD）风险。本研究旨在评估DCCB及其剂量效应与新诊断高血压患者患PD风险之间的关联。
这项基于人群的回顾性队列研究纳入了2001年至2013年间来自台湾国民健康保险研究数据库的107207例新诊断高血压患者。排除在高血压之前患有PD或在观察期结束前6个月内服用抗精神病药物超过30天的患者。使用Cox比例风险模型估计不同组中患PD的风险。根据累积限定日剂量（DDD）评估DCCB对PD风险的剂量相关效应。
在中位随访期分别为8.3年和6.2年期间，我们观察到接受DCCB治疗的患者中有832例（1.2%）发生PD，而未接受DCCB治疗的患者中有950例（2.4%）发生PD。DCCB治疗组患PD的风险（风险比[HR]=0.50）显著低于未接受DCCB治疗的组。DCCB以剂量依赖的方式降低了PD风险，对于90 - 180至>720的DDD，HR范围为0.61至0.37。
DCCB治疗与新诊断高血压患者患PD的风险显著降低相关。需要进一步的临床试验来证实DCCB对PD拟议的神经保护作用。
