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Lookup NU author(s): Professor David Burn
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background Cardiovascular disease (CVD) influences phenotypic variation in Parkinson's disease (PD), and is usually an indication for statin therapy. It is less clear whether cardiovascular risk factors influence PD phenotype, and if statins are prescribed appropriately.Objectives To quantify vascular risk and statin use in recent-onset PD, and examine the relationship between vascular risk, PD severity and phenotype.Methods Cardiovascular risk was quantified using the QRISK2 calculator (high >= 20%, medium >= 10 and <20%, low risk <10%). Motor severity and phenotype were assessed using the Movement Disorder Society Unified PD Rating Scale (UPDRS) and cognition by the Montreal cognitive assessment.Results In 2909 individuals with recent-onset PD, the mean age was 67.5 years (SD 9.3), 63.5% were men and the mean disease duration was 1.3 years (SD 0.9). 33.8% of cases had high vascular risk, 28.7% medium risk, and 22.3% low risk, while 15.2% of cases had established CVD. Increasing vascular risk and CVD were associated with older age (p<0.001), worse motor score (p<0.001), more cognitive impairment (p<0.001) and worse motor phenotype (p=0.021). Statins were prescribed in 37.2% with high vascular risk, 15.1% with medium vascular risk and 6.5% with low vascular risk, which compared with statin usage in 75.3% of those with CVD.Conclusions Over 60% of recent-onset PD patients have high or medium cardiovascular risk (meriting statin usage), which is associated with a worse motor and cognitive phenotype. Statins are underused in these patients, compared with those with vascular disease, which is a missed opportunity for preventive treatment.
Author(s): Swallow DMA, Lawton MA, Grosset KA, Malek N, Klein J, Baig F, Ruffmann C, Bajaj NP, Barker RA, Ben-Shlomo Y, Burn DJ, Foltynie T, Morris HR, Williams N, Wood NW, Hu MTM, Grosset DG, PRoBAND Clinical Consortium
Publication type: Article
Publication status: Published
Journal: Journal of Neurology, Neurosurgery and Psychiatry
Year: 2016
Volume: 87
Issue: 11
Pages: 1183-1190
Print publication date: 01/11/2016
Online publication date: 26/09/2016
Acceptance date: 17/07/2016
Date deposited: 12/01/2017
ISSN (print): 0022-3050
ISSN (electronic): 1468-330X
Publisher: BMJ Group
URL: http://dx.doi.org/10.1136/jnnp-2016-313642
DOI: 10.1136/jnnp-2016-313642
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