Association Between Cardiovascular Risk Factors and the Progression of Motor and Non-Motor Symptoms in Parkinson's...

Objective: To investigate the relationship between cardiovascular risk factors and the progression of motor and non-motor symptoms in Parkinson's disease (PD). Methods: We used data from the Parkinson's Progression Markers Initiative (PPMI) cohort with a follow-up duration of >5 years. Baseline assessments included genetic analysis, brain MRI, cardiovascular risk factors, and overall cardiovascular disease (CVD) risk. Motor symptoms and non-motor symptoms of PD were evaluated using the Movement Disorders Society revised Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and sub-scores, Hoehn-Yahr stage, and Montreal Cognitive Assessment (MoCA). Statistical analyses comprised univariate and multivariate linear regression and stratified analysis. Results: A total of 169 newly diagnosed PD patients and 78 healthy controls (HCs) were included. At baseline, no significant differences in cardiovascular risk factors or overall CVD risk were observed between PD patients and HCs. Hypertension (β = 6.748, p = 0.040) and hyperlipidemia (β = 8.316, p = 0.005) were associated with faster motor progression. ApoE genotype was correlated with motor progression (β = 7.593, p = 0.007). PD patients with a moderate-to-low CVD risk (<20%) had milder axial motor symptoms (3.0 [IQR, 4.0] vs. 4.0 [IQR, 5.0], p = 0.048) and lower MDS-UPDRS Part I total scores (7.0 [IQR, 6.25] vs. 9.0 [IQR, 7.0], p = 0.039) at last follow-up compared to high-CVD-risk (≥20%) patients. Overall CVD risk was negatively correlated with total MoCA score at last follow-up (β = -0.208, p< 0.001). Conclusions: Cardiovascular risk factors accelerate the progression of motor and non-motor symptoms in PD, suggesting that management of modifiable CVD risk factors may represent a promising target to delay the progression of PD.