Elsevier

The American Journal of Cardiology

Volume 136, 1 December 2020, Pages 56-61
The American Journal of Cardiology

Cardiovascular Risk Among Patients ≥65 Years of Age with Parkinson's Disease (From the National Inpatient Sample)

https://doi.org/10.1016/j.amjcard.2020.09.021Get rights and content

In this study, we aimed to investigate the relationship between Parkinson's disease (PD) and vascular disease and risk factors using a nationally representative sample. The National Inpatient Sample was queried for all patients aged ≥65 who were diagnosed with PD during the year 2016. Patients were identified using the International Classification of Diseases-Tenth Revision (ICD-10) diagnosis code: “G20.” Each patient diagnosed with PD was frequency-matched to controls at a 1:4 ratio by age and gender. Study outcomes were hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, and stroke. Outcomes were modeled using logistic regression analysis and further validation was obtained using a propensity score-matched analysis. A total of 57,914 patients (weighted: 289,570) with PD were included. Most patients were of Caucasian race (80.8%). Females were 42.4% and the mean age was 79 years, standard error of the mean (0.03). PD correlated with lower odds for hyperlipidemia adjusted odd ratio (a-OR): 0.77 (95% confidence interval [CI]: 0.75 to 0.79) p <0.001, diabetes mellitus a-OR 0.73 (95% CI 0.71 to 0.75) p <0.001, hypertension a-OR 0.68 (95% CI: 0.67 to 0.70) p <0.001, coronary artery disease a-OR 0.64 (95% CI: 0.63 to 0.66) p <0.001 and higher odds for stroke a-OR: 1.27 (95% CI: 1.24 to 1.31) p <0.001. Following propensity score matching, identical findings were found. In conclusion, patients with PD have a distinct cardiovascular profile with higher rates of stroke and lower rates of coronary artery disease and vascular disease risk factors.

Section snippets

Method

This study was conducted using the National Inpatient Sample (NIS) of the Health Care Utilization Project sponsored by the Agency for Healthcare Research and Quality.4 The NIS is a publicly available national registry that receives data from all US community hospital discharges. The NIS includes administrative as well as demographic data from a 20% sample of inpatient hospitalizations in the United States. NIS provides hospitalization information for over 7 million hospital stays each year with

Results

Table 1 summarizes the baseline characteristics of the study population. Overall a total of 57,914 patients (weighted: 289,570) with PD were included. Most patients were of the white race (80.8%). Women were 42.4% and the mean age was 79 years, standard error of the mean (0.03). Sepsis was the most common reason for admission for patients with and without PD (Supplementary Table 1). The results of the multivariable analysis were summarized in (Table 2). PD correlated with lower odds for

Discussion

The main findings of our study are plausibly explained by the impact of low sympathetic tone on cardiovascular factors among patients with PD. We found that patients with PD have a lower prevalence of diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease (CAD), and a higher prevalence of stroke.

The sympathetic nervous system maintains homeostasis and plays a pivotal role in the dynamics of cardiovascular risk factors and co-morbidities. It is typically activated during stress

Authors Contribution

AA: conceptualization, methodology, resources, formal analysis, visualization, writing - original draft. AT: writing - review & editing. MA: formal analysis, review & editing. PP: Writing - review & editing. IA: writing - review & editing. LK: supervision, writing - review & editing.

Disclosures

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Reference (20)

  • Q Hu et al.

    Mitochondrial dysfunction in Parkinson's disease

    Transl Neurodegener

    (2016)
  • DS Goldstein et al.

    Cardiac sympathetic denervation preceding motor signs in Parkinson disease

    Clin Auton Res Off J Clin Auton Res Soc

    (2007)
  • G Scigliano et al.

    Reduced risk factors for vascular disorders in parkinson disease patients

    Stroke

    (2006)
  • A Al-Sharea et al.

    Chronic sympathetic driven hypertension promotes atherosclerosis by enhancing hematopoiesis

    Haematologica

    (2019)
  • Anon. NIS Description of Data Elements. Available at:https://www.hcup-us.ahrq.gov/db/nation/nis/nisdde.jsp. Accessed...
  • Anon. DUA Training - Accessible Version. Available at:https://www.hcup-us.ahrq.gov/DUA/dua_508/DUA508version.jsp....
  • R Grissom et al.

    Effect sizes for research: univariate and multivariate applications, second edition

    Eff Sizes Res Univariate Multivar Appl Second Ed

    (2012)
  • MN Alshak et al.

    Neuroanatomy, sympathetic nervous system

    StatPearls

    (2020)
  • G Scigliano et al.

    Reduced risk factors for vascular disorders in Parkinson disease patients: a case-control study

    Stroke

    (2006)
  • M Alves et al.

    Does Parkinson's disease increase the risk of cardiovascular events? A systematic review and meta-analysis

    Eur J Neurol

    (2020)
There are more references available in the full text version of this article.

Cited by (0)

View full text