Am J Epidemiol. 2012 Mar 1. [Epub ahead of print]
Pasternak B, Svanström H, Nielsen NM, Fugger L, Melbye M, Hviid A.
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.
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