Reduced risk factors for vascular disorders in Parkinson disease patients: a case-control study.
OBJECTIVE
Sympathetic hyperactivity is a contributing cause of vascular disorders because it increases blood pressure, blood sugar, and blood lipids. Pervasive compromise of the central and peripheral autonomic nervous systems is common in idiopathic Parkinson disease (IPD) resulting in reduced sympathetic and parasympathetic function. We hypothesized that IPD was associated with reduced prevalence of cardiovascular disease risk factors as a result of reduced sympathetic activity.


METHODS
We performed a retrospective case-control study on 178 newly diagnosed consecutive IPD patients, and 533 age- (+/-3 years) and sex-matched controls with other neurological diseases seen over the same period at the same hospital. For each case and control the following were noted on admission: smoking, diabetes, hypertension, body mass index, serum glucose, plasma cholesterol, triglycerides and total lipid levels, and blood pressure.


RESULTS
Diabetes, history of smoking, high blood pressure, high blood glucose, high blood cholesterol, and triglycerides were significantly less frequent in IPD than controls.


CONCLUSIONS
IDP is a natural model of impaired hypothalamic-pituitary-adrenal axis activity and generalized sympathetic denervation. We interpret the association of untreated IPD with reduced vascular diseases risk factors as attributable to reduced autonomic activity, suggesting that autonomic hyperactivity may be involved in the pathogenesis of vascular disorders.
Istituto Nazionale Neurologico C. Besta, Via Celoria 11, 20131 Milan, Italy. giulioscigliano@tiscalinet.it
Giulio
G
Scigliano
Massimo
M
Musicco
Paola
P
Soliveri
Immacolata
I
Piccolo
Gabriele
G
Ronchetti
Floriano
F
Girotti
D000367:Age Factors; D000368:Aged; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000097:blood / Q000150:complications / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014280:Triglycerides / Q000097:blood; D014652:Vascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology
D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol