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Hypertension and Diagnosis of Parkinson's Disease: A Meta-Analysis of Cohort Studies.
Front Neurol. 2018; 9:162.FN

Abstract

Background

Hypertension has been associated with cognitive dysfunction in the general population and patients with Alzheimer's disease (AD). However, there are contradictory data regarding the potential association between hypertension and diagnosis of Parkinson's disease (PD), the second most common neurodegenerative disorder after AD. The purpose of this meta-analysis is to synthesize data from cohort studies to explore the potential association between preexisting hypertension and subsequent PD diagnosis.

Methods

The PubMed and Embase databases were searched to identify all relevant studies. Two independent investigators performed the data extraction. Eligible cohort studies providing risk and precision estimates related to hypertension and PD were selected. Pooled risk ratios (RRs) with 95% confidence interval (CI) were calculated by using a random-effects model or a fixed-effects model. Sensitivity analyses after excluding one study at a time were performed to assess the stability of the results. Publication bias was assessed with Begg's test and Egger's test.

Results

Seven cohort studies were identified, including 3,170 persons who were confirmed to have developed PD and 339,517 participants who did not have PD during follow-up. The onset of hypertension before PD diagnosis was significantly associated with an increased risk of motor stage PD (RR = 1.799, 95% CI [1.066-3.037]). This relationship was further confirmed by secondary analyses based on estimates adjusted for potential vascular confounders (RR = 1.319, 95% CI [1.073-1.622]). After excluding one study at a time, the sensitivity analyses still showed that hypertension history was significantly associated with an increased risk of motor stage PD (RR with 95% CI ranging from 1.11 [1.075-1.35] to 1.42 [1.65-1.83]). No publication bias was observed in this meta-analysis.

Conclusion

The findings of this meta-analysis suggest that hypertension may be a risk factor for motor stage PD, which may provide novel insights into the etiology and pathogenesis of this neurodegenerative disorder. However, large-scale well-designed studies that consider various confounders are still needed to further verify and clarify the association between hypertension and PD diagnosis.

Authors+Show Affiliations

School of Public Health, Dalian Medical University, Dalian, China.School of Public Health, Dalian Medical University, Dalian, China.School of Public Health, Dalian Medical University, Dalian, China.Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Ningxia, China.School of Public Health, Dalian Medical University, Dalian, China.Laboratory of Neurobiology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States.School of Public Health, Dalian Medical University, Dalian, China. Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China.School of Public Health, Dalian Medical University, Dalian, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29615961

Citation

Hou, Liyan, et al. "Hypertension and Diagnosis of Parkinson's Disease: a Meta-Analysis of Cohort Studies." Frontiers in Neurology, vol. 9, 2018, p. 162.
Hou L, Li Q, Jiang L, et al. Hypertension and Diagnosis of Parkinson's Disease: A Meta-Analysis of Cohort Studies. Front Neurol. 2018;9:162.
Hou, L., Li, Q., Jiang, L., Qiu, H., Geng, C., Hong, J. S., Li, H., & Wang, Q. (2018). Hypertension and Diagnosis of Parkinson's Disease: A Meta-Analysis of Cohort Studies. Frontiers in Neurology, 9, 162. https://doi.org/10.3389/fneur.2018.00162
Hou L, et al. Hypertension and Diagnosis of Parkinson's Disease: a Meta-Analysis of Cohort Studies. Front Neurol. 2018;9:162. PubMed PMID: 29615961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hypertension and Diagnosis of Parkinson's Disease: A Meta-Analysis of Cohort Studies. AU - Hou,Liyan, AU - Li,Qiujuan, AU - Jiang,Liping, AU - Qiu,Hongyan, AU - Geng,Chengyan, AU - Hong,Jau-Shyong, AU - Li,Huihua, AU - Wang,Qingshan, Y1 - 2018/03/19/ PY - 2017/10/10/received PY - 2018/03/05/accepted PY - 2018/4/5/entrez PY - 2018/4/5/pubmed PY - 2018/4/5/medline KW - Parkinson’s disease KW - Parkinson’s disease diagnosis KW - cohort studies KW - hypertension KW - meta-analysis SP - 162 EP - 162 JF - Frontiers in neurology JO - Front Neurol VL - 9 N2 - Background: Hypertension has been associated with cognitive dysfunction in the general population and patients with Alzheimer's disease (AD). However, there are contradictory data regarding the potential association between hypertension and diagnosis of Parkinson's disease (PD), the second most common neurodegenerative disorder after AD. The purpose of this meta-analysis is to synthesize data from cohort studies to explore the potential association between preexisting hypertension and subsequent PD diagnosis. Methods: The PubMed and Embase databases were searched to identify all relevant studies. Two independent investigators performed the data extraction. Eligible cohort studies providing risk and precision estimates related to hypertension and PD were selected. Pooled risk ratios (RRs) with 95% confidence interval (CI) were calculated by using a random-effects model or a fixed-effects model. Sensitivity analyses after excluding one study at a time were performed to assess the stability of the results. Publication bias was assessed with Begg's test and Egger's test. Results: Seven cohort studies were identified, including 3,170 persons who were confirmed to have developed PD and 339,517 participants who did not have PD during follow-up. The onset of hypertension before PD diagnosis was significantly associated with an increased risk of motor stage PD (RR = 1.799, 95% CI [1.066-3.037]). This relationship was further confirmed by secondary analyses based on estimates adjusted for potential vascular confounders (RR = 1.319, 95% CI [1.073-1.622]). After excluding one study at a time, the sensitivity analyses still showed that hypertension history was significantly associated with an increased risk of motor stage PD (RR with 95% CI ranging from 1.11 [1.075-1.35] to 1.42 [1.65-1.83]). No publication bias was observed in this meta-analysis. Conclusion: The findings of this meta-analysis suggest that hypertension may be a risk factor for motor stage PD, which may provide novel insights into the etiology and pathogenesis of this neurodegenerative disorder. However, large-scale well-designed studies that consider various confounders are still needed to further verify and clarify the association between hypertension and PD diagnosis. SN - 1664-2295 UR - https://www.unboundmedicine.com/medline/citation/29615961/Hypertension_and_Diagnosis_of_Parkinson's_Disease:_A_Meta_Analysis_of_Cohort_Studies_ L2 - https://doi.org/10.3389/fneur.2018.00162 DB - PRIME DP - Unbound Medicine ER -
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