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Understanding the links between cardiovascular disease and Parkinson's disease
Judy Potashkin1, Xuemei Huang2, Claudia Becker3
1The Cellular and Molecular Pharmacology Department, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA.
Insights
Parkinson's disease (PD) and cardiovascular disease share some risk factors like age and sex, but also protective factors like coffee and exercise. Understanding these links is key for tailored patient care.
Area of Science:
- Neuroscience
- Cardiology
- Epidemiology
Background:
- Parkinson's disease (PD) and cardiovascular disease (CVD) share several epidemiological risk factors, including older age, male sex, and type 2 diabetes.
- Conversely, factors such as coffee consumption and physical activity are associated with a reduced risk for both PD and CVD.
- These concordant and discordant associations suggest underlying pathophysiological links warranting further investigation.
Purpose of the Study:
- To review the epidemiological evidence for shared and opposing risk factors between Parkinson's disease and cardiovascular disease.
- To discuss potential common cellular and metabolic mechanisms linking PD and CVD.
- To explore the clinical implications for managing cardiovascular risk factors in PD patients.
Main Methods:
- Systematic review of epidemiological studies examining associations between PD and CVD.
- Analysis of shared risk factors (e.g., age, sex, diabetes, smoking, cholesterol) and protective factors (e.g., coffee, physical activity).
- Discussion of potential common pathophysiological pathways including glucose metabolism, inflammation, cellular stress, and lipid metabolism.
Main Results:
- Concordant associations found for older age, male sex, and type 2 diabetes as risk factors for both PD and CVD.
- Discordant associations observed for smoking and LDL cholesterol, which increase CVD risk but may decrease PD risk.
- Protective associations noted for coffee consumption and physical activity against both PD and CVD.
Conclusions:
- The relationship between cardiovascular disease and Parkinson's disease is complex, with both shared and opposing risk factors.
- Common mechanisms in metabolism and inflammation may underlie these associations.
- A nuanced approach to managing cardiovascular risk factors in PD patients is necessary, potentially tailored to individual comorbidity profiles.
Abstract:
Studies investigating the associations between genetic or environmental factors and Parkinson's disease (PD) have uncovered a number of factors shared with cardiovascular disease, either as risk factors or manifestations of cardiovascular disease itself. Older age, male sex, and possibly type 2 diabetes are examples. On the other hand, coffee consumption and physical activity are each associated with a lower risk of both PD and cardiovascular disease. This observation raises questions about the underlying pathophysiological links between cardiovascular disease and PD. There is evidence for common mechanisms in the areas of glucose metabolism, cellular stress, lipid metabolism, and inflammation. On the other hand, smoking and total/low-density lipoprotein cholesterol appear to have opposite associations with cardiovascular disease and PD. Thus, it is uncertain whether the treatment of cardiovascular risk factors will impact on the onset or progression of PD. The available data suggest that a nuanced approach is necessary to manage risk factors such as cholesterol levels once the associations are better understood. Ultimately, the choice of therapy may be tailored to a patient's comorbidity profile. This review presents the epidemiological evidence for both concordant and discordant associations between cardiovascular disease and PD, discusses the cellular and metabolic processes that may underlie these links, and explores the implications this has for patient care and future research. © 2019 International Parkinson and Movement Disorder Society.