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Statins are underused in recent-onset Parkinson's disease with increased vascular risk : findings from the UK Tracking Parkinson's and Oxford Parkinson's Disease Centre (OPDC) discovery cohorts

Swallow, Diane M A; Lawton, Michael A; Grosset, Katherine A; Malek, Naveed; Klein, Johannes; Baig, Fahd; Ruffmann, Claudio; Bajaj, Nin P; Barker, Roger A LU and Ben-Shlomo, Yoav, et al. (2016) In Journal of Neurology, Neurosurgery and Psychiatry 87(11). p.1183-1190
Abstract

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... (More)

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.

TRIAL REGISTRATION NUMBER: GN11NE062, NCT02881099.

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publication status
published
subject
keywords
Parkinson disease, Statins
in
Journal of Neurology, Neurosurgery and Psychiatry
volume
87
issue
11
pages
8 pages
publisher
BMJ Publishing Group
external identifiers
  • scopus:84988921991
ISSN
1468-330X
DOI
10.1136/jnnp-2016-313642
language
English
LU publication?
yes
id
2863c9be-4745-411c-9a54-20506b646c2a
date added to LUP
2016-11-23 13:04:00
date last changed
2017-11-19 04:35:05
@article{2863c9be-4745-411c-9a54-20506b646c2a,
  abstract     = {<p>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.</p><p>OBJECTIVES: To quantify vascular risk and statin use in recent-onset PD, and examine the relationship between vascular risk, PD severity and phenotype.</p><p>METHODS: Cardiovascular risk was quantified using the QRISK2 calculator (high ≥20%, medium ≥10 and &lt;20%, low risk &lt;10%). Motor severity and phenotype were assessed using the Movement Disorder Society Unified PD Rating Scale (UPDRS) and cognition by the Montreal cognitive assessment.</p><p>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&lt;0.001), worse motor score (p&lt;0.001), more cognitive impairment (p&lt;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.</p><p>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.</p><p>TRIAL REGISTRATION NUMBER: GN11NE062, NCT02881099.</p>},
  author       = {Swallow, Diane M A and Lawton, Michael A and Grosset, Katherine A and Malek, Naveed and Klein, Johannes and Baig, Fahd and Ruffmann, Claudio and Bajaj, Nin P and Barker, Roger A and Ben-Shlomo, Yoav and Burn, David J and Foltynie, Thomas and Morris, Huw R and Williams, Nigel and Wood, Nicholas W and Hu, Michele T M and Grosset, Donald G},
  issn         = {1468-330X},
  keyword      = {Parkinson disease,Statins},
  language     = {eng},
  number       = {11},
  pages        = {1183--1190},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Neurology, Neurosurgery and Psychiatry},
  title        = {Statins are underused in recent-onset Parkinson's disease with increased vascular risk : findings from the UK Tracking Parkinson's and Oxford Parkinson's Disease Centre (OPDC) discovery cohorts},
  url          = {http://dx.doi.org/10.1136/jnnp-2016-313642},
  volume       = {87},
  year         = {2016},
}