Abstract
(1) Background: Parkinson’s disease and arterial hypertension are likely to coexist in the elderly, with possible bidirectional interactions. We aimed to assess the role of antihypertensive agents in PD emergence and/or progression. (2) We performed a systematic search on the PubMed database. Studies enrolling patients with Parkinson’s disease who underwent treatment with drugs pertaining to one of the major antihypertensive drug classes (β-blockers, diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and calcium-channel blockers) prior to or after the diagnosis of parkinsonism were scrutinized. We divided the outcome into two categories: neuroprotective and disease-modifying effect. (3) We included 20 studies in the qualitative synthesis, out of which the majority were observational studies, with only one randomized controlled trial. There are conflicting results regarding the effect of antihypertensive drugs on Parkinson’s disease pathogenesis, mainly because of heterogeneous protocols and population. (4) Conclusions: There is low quality evidence that antihypertensive agents might be potential therapeutic targets in Parkinson’s disease, but this hypothesis needs further testing.
Highlights
Parkinson’s disease (PD) is the most common neurodegenerative movement disorder, with an incidence ranging from 5 to 35 cases per 100,000 population yearly and a prevalence that increases from 1% of people aged 45–54 to 4% of men older than 85 years [1]
We designed a systematic review centered on the following research question: “Does hypertension medication pertaining to major antihypertensive drug classes exert neuroprotective and/or disease-modifying effects in a dose and timedependent manner in adult patients with sporadic PD regardless of blood pressure values?”
Fifteen studies investigated whether the exposure to antihypertensive agents is a protective factor for PD emergence, whereas five studies explored the effect of antihypertensive therapy on PD progression
Summary
Parkinson’s disease (PD) is the most common neurodegenerative movement disorder, with an incidence ranging from 5 to 35 cases per 100,000 population yearly and a prevalence that increases from 1% of people aged 45–54 to 4% of men older than 85 years [1]. The biomedical and economic burden of PD has increased dramatically as a result of population ageing [2]. In his “Essay on the Shaking Palsy”, James Parkinson made some “considerations respecting the means of cure” and concluded that “nothing direct and satisfactory has been obtained”. More than 200 years later, this statement is still true: despite extensive research efforts, there are no curative/disease-modifying therapies or neuroprotective interventions in PD.
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