Use of Calcium Channel Blockers and Parkinson’s Disease

• Published in: American journal of epidemiology Vol. 175; no. 7; pp. 627 - 635
• Main Authors: Pasternak, Björn, Svanström, Henrik, Nielsen, Nete M., Fugger, Lars, Melbye, Mads, Hviid, Anders
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 01.04.2012; Oxford Publishing Limited (England)
• Subjects: Age Factors; Aged; Biological and medical sciences; Calcium Channel Blockers - therapeutic use; Calcium channels; Cohort Studies; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia disorders; Denmark - epidemiology; Dihydropyridines - therapeutic use; Drug therapy; Epidemiology; Female; General aspects; Humans; Incidence; Male; Medical sciences; Middle Aged; Miscellaneous; Mortality; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Older people; Parkinson Disease - epidemiology; Parkinson Disease - prevention & control; Parkinson's disease; Poisson Distribution; Propensity Score; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Statins; Denmark; Nervous system diseases; Parkinson's disease; calcium channel blockers; Use; Calcium antagonist; Parkinson disease; antihypertensive agents; Epidemiology; Cerebral disorder; Neurology; Central nervous system disease; Antihypertensive agent; Degenerative disease; Public health; Extrapyramidal syndrome
• ISSN: 0002-9262; 1476-6256; 1476-6256
• DOI: 10.1093/aje/kwr362

Experimental evidence and case-control studies suggest that dihydropyridine calcium channel blockers (DiCCBs) may protect against Parkinson's disease. The authors conducted a historical cohort study in Denmark to investigate the association between DiCCB use and risk of Parkinson's disease (1998-2006). Individual-level data on filled drug prescriptions, diagnostic information, and covariates were linked between nationwide registries. Among DiCCB users, 173 incident cases of Parkinson's disease were detected during 461,984 person-years of follow-up, compared with 5,538 cases during 17,343,641 person-years of follow-up among nonusers. After adjustment for age, sex, year, propensity score, and use of other antihypertensive drugs and statins, DiCCB use was associated with a reduced risk of Parkinson's disease (rate ratio (RR) = 0.71, 95% confidence interval (CI): 0.60, 0.82). This association was not present in patients who had previously used DiCCBs (RR = 1.04, 95% CI: 0.87, 1.24). DiCCB users aged ≥65 years were at lower risk of Parkinson's disease than DiCCB users aged <65 years (RR = 0.59, 95% CI: 0.40, 0.85). Among patients with Parkinson's disease, DiCCB use was associated with reduced risk of death (adjusted RR = 0.66, 95% CI: 0.47, 0.91) but not dementia (adjusted RR = 0.97, 95% CI: 0.60, 1.56). In conclusion, DiCCB exposure was associated with a reduced risk of incident Parkinson's disease, particularly in older patients, and with reduced mortality among patients with Parkinson's disease.