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, D. M.A. et al. (2016) 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. Journal of Neurology, Neurosurgery and Psychiatry, 87(11), pp. 1183-1190. (doi: 10.1136/jnnp-2016-313642) (PMID:27671901) (PMCID:PMC5116532)

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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 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.

Item Type:Articles
Additional Information:on behalf of PRoBaND Clinical Consortium.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Swallow, Dr Diane and Grosset, Dr Donald and Grosset, Dr Katherine
Authors: Swallow, D. M.A., Lawton, M. A., Grosset, K. A., Malek, N., Klein, J., Baig, F., Ruffmann, C., Bajaj, N. P., Barker, R. A., Ben-Shlomo, Y., Burn, D. J., Foltynie, T., Morris, H. R., Williams, N., Wood, N. W., Hu, M. T.M., and Grosset, D. G.
College/School:College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
Journal Name:Journal of Neurology, Neurosurgery and Psychiatry
Publisher:BMJ Publishing Group
ISSN:0022-3050
ISSN (Online):0022-3050
Published Online:26 September 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Journal of Neurology, Neurosurgery and Psychiatry 87(11):1183-1190
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
525044PROBAND: Parkinson's repository of biosamples and networked datasetsDonald GrossetParkinson's Disease Society (PARKINSONS)J-1101RI NEUROSCIENCE & PSYCHOLOGY