Serviço de Medicina III, Hospital Pulido Valente, CHULN, Lisboa, Portugal.
Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Eur J Neurol. 2021 Aug;28(8):2669-2679. doi: 10.1111/ene.14938. Epub 2021 Jun 16.
The relationship between Parkinson's disease (PD) and cardiovascular and cerebrovascular disease is not yet well established. Recent data suggest an increased risk of myocardial infarction and stroke in PD patients. Therefore, we designed a study to assess surrogate markers of cardiovascular and cerebrovascular risk in PD.
We conducted a case-control study comparing PD patients recruited from a Movement Disorders Unit with controls randomly invited from a primary healthcare center. All participants underwent a detailed clinical evaluation, including medical history, physical assessment, carotid ultrasound, blood and urine analysis, and 24-h ambulatory blood pressure monitoring. The primary outcome was the carotid intima-media thickness (CIMT).
We included 102 participants in each study arm. No significant difference was found in the CIMT among groups (MD: 0.01, 95% CI: -0.02, 0.04). Carotid plaques were more frequent in PD patients (OR: 1.90, 95% CI: 1.02, 3.55), although the lipid profile was more favorable in this group (LDL MD: -18.75; 95% CI: -10.69, -26.81). Nocturnal systolic blood pressure was significantly higher in PD patients (MD: 4.37, 95% CI: 0.27, 8.47) and more than half of the PD patients were non-dippers or reverse dippers (OR: 1.83, 95% CI: 1.04, 3.20).
We did not find a difference in CIMT between PD and controls. A higher frequency of carotid plaques and abnormal dipper profile supports the hypothesis that PD patients are not protected from cardiovascular and cerebrovascular disease.
帕金森病(PD)与心血管和脑血管疾病之间的关系尚未得到充分证实。最近的数据表明,PD 患者心肌梗死和中风的风险增加。因此,我们设计了一项研究来评估 PD 患者心血管和脑血管风险的替代标志物。
我们进行了一项病例对照研究,将从运动障碍科招募的 PD 患者与从初级保健中心随机邀请的对照组进行比较。所有参与者都接受了详细的临床评估,包括病史、身体评估、颈动脉超声、血液和尿液分析以及 24 小时动态血压监测。主要结局是颈动脉内膜中层厚度(CIMT)。
我们在每个研究组中纳入了 102 名参与者。组间 CIMT 无显著差异(MD:0.01,95%CI:-0.02,0.04)。PD 患者颈动脉斑块更为常见(OR:1.90,95%CI:1.02,3.55),尽管该组的血脂谱更为有利(LDL MD:-18.75;95%CI:-10.69,-26.81)。PD 患者夜间收缩压明显升高(MD:4.37,95%CI:0.27,8.47),超过一半的 PD 患者是非杓型或反杓型(OR:1.83,95%CI:1.04,3.20)。
我们未发现 PD 与对照组之间 CIMT 存在差异。颈动脉斑块发生率较高和异常杓型血压提示 PD 患者不能免受心血管和脑血管疾病的影响。