Objective: To assess the relationships of long-term blood pressure (BP) measures and incident Parkinson’s disease (PD) in the Framingham Heart Study (FHS) cohort.

Background: Long-term BP measures are indicators of cardiovascular (CV) risk, and CV risk factors are implicated in the development of PD [1-7]. Autonomic dysfunction occurs in PD, with worsening orthostatic hypotension and blood pressure variability (BPV) in later disease and is associated with greater white matter disease burden and motor dysfunction. Early autonomic dysfunction can also occur in prodromal and early PD [8-14].  FHS is a multigenerational longitudinal cohort study that was started in 1948, which is well-known for its extensive CV health data. In this study, we assessed the relationship of long-term BP measures and incident PD.

Method: Participants in the FHS Original and Offspring cohorts were included in this case-control study. Controls (HC) were selected based on sex, age on PD onset and FHS cohort with a 1:4 case-control ratio. Data was assessed over a 30-year period, and participants attended at least three health visits. BPV is assessed for both systolic (SBP) and diastolic blood pressures (DBP) using three metrics: 1) standard deviation, 2) adjusted cumulative blood pressure and 3) trajectory over time. Student’s t-test was used to assess each BPV metrics between cases and controls. Results were also weighted by number of examinations attended for each participant. PD diagnoses were made by a panel of movement disorders neurologists using the UK Brain Bank Criteria and other supporting clinical details. We used p<0.05 for significance.

Results: A total of 172 PD cases (57% male) and 653 HC (58% male) were included in the analyses, average age of PD onset was 74.9 years. The meanage between first and last examination was approximately 23 years for both groups (Table 1). The mean standard deviation (STD) for longitudinal SBP was 12.28 (4.79) for cases and 14.24 (6.34) for HC (p <0.001). Mean STD for longitudinal DBP was 6.95 (2.67) and 8.26 (3.48) for HC, p <0.001.

Conclusion: Over time, participants who developed PD had less BPV compared to HC, which suggests that PD participants in this cohort may not have prodromal autonomic dysfunction. PD participants also had significantly lower absolute SBP compared to HC. Future analyses will use regression modeling to confirm these findings.

Table 1

Table 2

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-blood-pressure-measures-in-incident-parkinsons-disease-in-the-framingham-heart-study/