Objective: Our primary aim was to study the effect of beta – blockers on the dynamics of extrapyramidal disorders in patients suffering from coronary heart disease (CHD) in combination with vascular parkinsonism.

Background: Vascular parkinsonism and CHD are not rare diseases for our region due to specific life-style in Uzbekistan, it was interesting for us to know the treatment of these pathologies in our area.

Methods: The study involved 62 patients with CHD and vascular parkinsonism at the departments of Therapy, Cardiology and Neurology at the 1st clinic of the Tashkent Medical Academy. Patients were divided into 2 groups. Group I consised of 33 patients, who were taking bisoprolol 5 mg / day as a basic treatment of coronary artery disease. Group II consisted of 29 patients who received ivabradine hydrochloride 10 mg/day as a basic therapy of CHD. The average dose of L-dopa in two groups was 475 mg / day. Severity of symptoms was assessed by standardized rating scale manifestations of Parkinson’s disease (UPDRS). Extrapyramidal disorders in groups I and II were identical and expressed by hypokinesia, stiffness, easy rest tremor and postural instability. Severity of these symptoms in the group I was 28,7% ± score that didn’t differ significantly from the data of group II in 28,5% ± 1,8 points.

Results: During therapy extrapyramidal symptoms in group I were significantly increased compared with those in group II to 33,4% ± 2,0 points, and the dose of L-dopa had to be enlarged on 50-75 mg / day. In the second group it was 28,9% ± 1,9 points, but the dose of L-dopa remained unchanged. It should also be noted that dyskinesia appeared in patients from group I, probably due to the mechanisms of action of b-blockers, particularly by their effect on cerebral vessel’s tone (spasm).

Conclusions: The study showed that it’s undesirable to use beta-blockers in patients with coronary heart disease combined with vascular parkinsonism, what worsen the flow of vascular parkinsonism, leading to increase of the dose of L-dopa and as a result to enhance of it’s such side effect as appearing of early dyskinesia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/beta-blockers-worsen-vascular-parkinsonism-in-patients-with-concomitant-coronary-heart-disease/