The impact of cardiovascular disease on Parkinson's disease: Findings from the PPMI study

BACKGROUND Parkinson's disease (PD) is a neurodegenerative disorder in which age is the strongest risk factor, but the role of cardiovascular disease (CVD) remains unclear. This study examines the impact of CVD history on PD onset and progression. METHODS We conducted a cross-sectional analysis using data from the Parkinson's Progression Markers Initiative (PPMI), involving 1109 participants (924 PD patients and 185 healthy controls). The correlation of CVD history with PD and its progression (motor and non-motor symptoms assessed with Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS I-IV), autonomic dysfunction assessed with Scales for Outcomes in PD-Autonomic Dysfunction (SCOPA-AUT), and cognitive impairment assessed with Montreal Cognitive Assessment (MoCA)) was evaluated using regression models. RESULTS Participants had a mean age of 62.84 ± 9.64 years (61 % male), with no significant group differences in CVD history (P = 0.382). CVD history was not associated with PD occurrence, even after matched comparison. PD participants were predominantly early-stage with a mean follow-up of 4.84 ± 4.67 years. CVD history showed no association with autonomic or cognitive outcomes but was associated with a higher risk of motor complications (MDS-UPDRS IV: OR:3.34, 95 %CI:1.38-8.63, P = 0.009), with no effects on other MDS-UPDRS categories; progression-based analyses likewise showed no impact on autonomic or cognitive function (P > 0.05). CONCLUSIONS CVD history does not independently predict PD incidence or autonomic or cognitive progression but may increase the risk of motor complications. These findings should be interpreted cautiously due to the predominance of early-stage PD patients and small subgroup sizes, and require further validation.