Understanding The Links Between Cardiovascular Disease And Parkinson’s Disease
Judy Potashkin PhD
The Cellular and Molecular Pharmacology Department, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
Claudia Becker PhD
Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
The Edmond J Safra Program in Parkinson’s Research, Toronto Western Hospital, University of Toronto, Toronto, Canada
Correspondence to:
Judy Potashkin PhD
The Cellular and Molecular Pharmacology Department, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
Claudia Becker PhD
Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
The Edmond J Safra Program in Parkinson’s Research, Toronto Western Hospital, University of Toronto, Toronto, Canada
Correspondence to:
Pesticides And Pd Risk
Pesticides and occupational exposure to chemicals can increase the risk of PD176,177. Paraquat is the chemical most linked to risk, and even rotenone, a natural plant-derived pesticide used by home gardeners, has been associated with disease178. Both compounds inhibit mitochondrial respiration, which could impact an already dysfunctional endolysosomal pathway in individuals with particular genetic mutations179,180. In addition to paraquat and rotenone, exposure to the toxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine , after its accidental discovery as an agent that caused dopaminergic neuronal loss in humans during recreational drug use, has become one of the main methods to induce dopaminergic neuronal loss and degeneration in animal models181183. Studies have shown that paraquat, rotenone and MPTP all induce both central and peripheral inflammation and oxidative stress184188.
Symptoms Of Parkinsons Disease
These common symptoms of Parkinsons disease often begin gradually and progress over time:
- Shaking or tremor
- Poor posture
- Slowing of body movements
As the disease continues to progress, additional symptoms can occur such as slurred or soft speech, trouble chewing and/or swallowing, memory loss, constipation, trouble sleeping, loss of bladder control, anxiety, depression, inability to regulate body temperature, sexual dysfunction, decreased ability to smell, restless legs and muscle cramps.
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Heart Damage Could Be Early Indicator Of Parkinsons
Parkinsons disease is most widely known for causing muscle tremors and motor-control symptoms, but most Parkinsons sufferers also exhibit damage to their hearts connection to the sympathetic nervous system. In fact, that damage is one of the first signs of Parkinsons, but the connection is often not made until the more visible symptoms develop.
Researchers at theWisconsin National Primate Research Center and the University of Wisconsin have found a new way to examine stress and inflammation in the heart that could serve as an early indicator of Parkinsons well before the more common symptoms begin.
The heart damage is significant because it contributes to a tendency for Parkinsons patients to suffer physical injury as a result of blood pressure fluctuations.
This neural degeneration in the heart means patients bodies are less prepared to respond to stress and to simple changes like standing up, said, a University of WisconsinMadison professor of medical physics and Parkinsons researcher at the WiNPRC. They have increased risk for fatigue, fainting and falling that can cause injury and complicate other symptoms of the disease.
The sympathetic nervous system signals the heart to accelerate its pumping to match quick changes in activity and blood pressure. Researchers at WiNPRC developed a method for tracking the mechanisms that cause the damage to heart nerve cells, then tested the method in the nervous system and heart of monkeys.
Viral Infection And Pd
PD is the second most common neurodegenerative disorder and most common neurodegenerative motor disorder. It is associated with degeneration and eventual loss of dopaminergic neurons from the substantia nigra pars compacta of the midbrain. Mitochondrial dysfunction, oxidative stress, microglia and astrocyte activation leading to, autophagy disruption and uncontrolled protein aggregation involving -synuclein have also been described . Neuroinflammation has been implicated in the progression of this disease, by which microglia become chronically activated in response to -synuclein pathology and dying neurons, thereby acquiring phenotypes that are cytotoxic and can cause further neuronal death . This results in a significant reduction in dopaminergic activity in the nigrostriatal pathway contributing to disease symptoms such as resting tremor, rigidity, bradykinesia and unstable posture. Non-motor symptoms such as olfactory dysfunction, dysphagia, constipation, sleep disturbances and dementia have also been described .
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What Does This Mean For People With Parkinsons
Professor Donald Grosset, leader of the Tracking Parkinsons study and one of the authors of the study, explains:
Its not surprising that many people living with Parkinsons also have an increased risk of cardiovascular disease as both conditions get more common as we get older.
But our study highlights the impact of living with both at the same time.
People with poorer cardiovascular health had worse walking and memory even in the early stages of Parkinsons, so improving cardiovascular health may help these aspects of the condition.
We were slightly surprised that so few people in the high and medium risk groups were taking statins, since they are proven to reduce the risk of heart attacks and strokes.
We hope our findings will help to start a conversation about vascular health in Parkinsons, so that it can be assessed and, where appropriate, treated.
Heres What To Do If You Notice Terrys Nails
While there is no specific treatment for this symptom, its likely to lessen with treatment of the underlying condition. Besides medical interventions suggested by your doctor, the CDC recommends practicing healthy habits that lower your likelihood of congestive heart failure. These include not smoking tobacco eating healthy foods that are low in fat, cholesterol and sodium exercising regularly and limiting your alcohol intake.
Speak with your doctor if you notice any changes to the color of your nails, especially if you have any known history of a heart or liver condition.
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Myth : Deep Brain Stimulation Is Experimental Therapy
Fact: Deep brain stimulation, or DBS, is a procedure in which doctors place electrodes in the brain at the point when medications are less effective in masking motor symptoms, such as tremor, stiffness and slowness of movement.
While it may sound frightening and futuristic, its been around and successfully used for decades. DBS works very similarly to a pacemaker, except the wire is in the brain, not in the heart. Its been a standard procedure for the past two decades.
Two Areas In Which Parkinsons Disease May Bring About Death
I. Falls
PD patients are at an increased risk of falling and bad falls can lead to death. This usually occurs as a complication of a fall that requires hospitalization, particularly if it involves surgery. While most people do not fracture their hips when they fall, some do, and hip surgery, while routine, is still major surgery. It carries the risk of infection, delirium related to pain medications and anesthesia, heart failure, pneumonia, blood clots in the legs that then go to the lungs, and general weakness from immobility. Hip fractures are probably the main cause for death for those who fall, but people can fracture other bones and require surgery. They may fracture their ribs, which leads to reduced coughing, because of the pain, and an increased risk of lung infections . It is surprisingly uncommon for Parkinsons Disease patients to die from brain injuries related to falls, but it still may occur.
II. Pneumonia
PD patients also may develop pneumonias completely unrelated to difficulties with swallowing, just like their non-PD friends and relatives.
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Parkinsons Disease: Patient Guide To Covid
Dealing with Parkinsons Disease poses its own challenges, but managing your disease while worrying about the current pandemic can be even more stressful. Here are some basic questions answered, about navigating the coronavirus pandemic with Parkinsons Disease.
The last few weeks have been challenging for everyone, and the challenges will most likely continue for several more weeks. All of our lives have been significantly interrupted by this pandemic. Many of us are experiencing anxiety, and there are more questions than answers. Your family at the Pacific Movement Disorders Center is here to help you navigate through this difficult time by answering some questions you may have regarding to COVID-19. Please note that our advice and answers may shift as new information comes in.
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Having A Healthy Sex Life
Most people with heart failure can still have an active and safe sex life. Talk with your doctor if you have concerns about having sex.
Unfortunately, sexual problems are common. Your interest may drop, or you may have shortness of breath or other symptoms that limit your ability to have sex. Men may have erection problems.
Talk to your doctor. You can get help for erection problems or other sexual troubles.
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Environmental Factors And Exposures
Exposure to pesticides and a history of head injury have each been linked with PD, but the risks are modest. Never drinking caffeinated beverages is also associated with small increases in risk of developing PD.
Low concentrations of urate in the blood is associated with an increased risk of PD.
Drug-induced parkinsonism
Different medical drugs have been implicated in cases of parkinsonism. Drug-induced parkinsonism is normally reversible by stopping the offending agent. Drugs include:
Caring For Your Health With Parkinson’s Disease
In addition to caring for your Parkinson’s health, it is also important to care for your overall health. This means visiting your primary care physician periodically for preventive care like the annual flu shot and cancer screeningsfor example, a mammogram for breast cancer screening and a colonoscopy for colon cancer screening.
A primary care physician can also evaluate for risk factors related to heart attacks and strokes, and provide counseling on exercise, smoking, alcohol use, depression, or other mental health concerns. Regular visits to your primary care physician or neurologist will also allow them to catch bacterial infections like urinary tract infections before they get serious.
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Ways To Decrease Risk Of Heart Disease
As in the general population, heart disease in people with PD can be decreased by managing traditional risk factors:
- Smoking cessation According to the American Heart Association, smoking is the most preventable cause of premature death in the U.S. Smoking increases the risk of developing many chronic disorders, including atherosclerosis that can lead to heart disease and stroke.3
- Treatment of high blood pressure Approximately 90% of all Americans will develop hypertension, or high blood pressure, over their lifetime. Hypertension puts more stress on arteries and can cause damage over time.3
- Treatment of high cholesterol High cholesterol is one of the major controllable risk factor for heart disease. When too much LDL cholesterol is in the blood, it can build up in the artery walls and narrow the vessels that feed the heart and brain.3
- Control of diabetes Diabetes can affect many major organs in the body, including the heart. Fortunately, diabetes is treatable and often preventable.3
Congestive Heart Failure And Parkinson’s
The onward motion of parkinsons symptoms varies betwixt people. Health conditions that put you at increased risk of seborrheic dermatitis let in congestive heart failure, parkinsons disease and hiv/aids. Life-style changes, including regular exercise and a levelheaded dieting. It was a unspeakable modulation and a meaning ethnical shift for the company. They found that higher midlife bmi was importantly connected with a greater burden of neurofibrillary tangles, but not with a greater amyloid memorial tablet load. In summation, crist said toepperwein is a model of resiliency once veneer a parkinsons diagnosing. A second good tidings determination from the research is that the scientists were able-bodied to extenuate and even reverse the personal effects of parkinsons disease in both brute models and cellphone cultures exploitation apresoline, a drug secondhand to treat high descent pressure and congestive heart failure. Some persons, by nerve-wracking not to shuffle, may in reality outdo their safe limits of walk and, as a result fall back their balance.
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How Is It Treated
Most people with heart failure need to take several medicines. Your doctor may prescribe medicines to:
- Help keep heart failure from getting worse. These drugs include ACE inhibitors, angiotensin II receptor blockers , beta-blockers, and vasodilators like hydralazine and a nitrate.
- Reduce symptoms so you feel better. These drugs include diuretics and digoxin.
- Treat the cause of your heart failure.
It is very important to take your medicines exactly as your doctor tells you to. If you don’t, your heart failure could get worse.
Pacemaker or defibrillator
A pacemaker or a defibrillator may be an option for you if you have a problem with your heart rhythm. A pacemaker can help your heart pump blood better. A defibrillator can prevent a dangerous heart-rhythm problem.
Care at home
Lifestyle changes are an important part of treatment. They can help slow down heart failure. They may also help control other diseases that make heart failure worse, such as high blood pressure, diabetes, and coronary artery disease.
The best steps you can take are to:
Ask your doctor if cardiac rehab is right for you. Rehab can give you education and support that help you learn self-care and build new healthy habits, such as exercise and healthy eating.
To stay as healthy as possible, work closely with your doctor. Have all your tests, and go to all your appointments. It is also important to:
Heart Attack Survivors Less Likely To Get Parkinsons Disease Later In Life
AARHUS, Denmark Theres nothing good about suffering from a heart attack, but one study reveals a surprising benefit for patients. Heart attack survivors are less likely to get Parkinsons disease later in life, research shows.
Scientists at Aarhus University in Denmark find that people who suffered a heart attack saw a 20 percent lower risk of developing the debilitating condition. The study also shows that heart attack patients have a 28 percent lower risk of getting secondary Parkinsonism, a condition which has similar symptoms.
Heart disease and Parkinsons share many risk factors. Elderly men are at a higher risk while people who drink lots of coffee and are more physically active are at lower risk from both conditions. However, some of the classic risk factors for heart attacks such as smoking, high cholesterol, high blood pressure and Type-2 diabetes are actually linked to a lower risk of Parkinsons.
The Danish-led research team found their findings somewhat surprising. Similarly, Parkinsons disease may be one of the few diseases for which smoking reduces your risk, but that does not make it good for your health, the researchers add.
For the study, the authors looked at the records of 182,000 Danish people who had had a first-time heart attack between 1995 and 2016, and compared them with the records of 909,000 other Danes. The patients studied had an average age of 71, most of them were men and their health was followed up over 21 years.
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Treatment For Causes Of Heart Failure
If you have other heart problems that may have led to heart failure, you might have treatment for those problems:
- Coronary artery bypass surgery or angioplasty.
- Surgery to replace or repair a valve in your heart.
- Cardiac rehabilitation, a supervised program that uses exercise, education, and support to help people live well with heart failure. For more information, see the topic Cardiac Rehabilitation.
Sometimes heart failure can be fixed if another problem can be corrected, such as by treating hyperthyroidism.
Research Is Underway To Further Understand The Cardiac Effects Of Parkinsons
It is possible to image the sympathetic nervous system of the human heart by injecting a radioactive tracer, meta-iodo-benzyl-guanidine, . Development of this technique, known as MIBG cardiac imaging, holds much promise as a test to confirm the diagnosis of PD , to identify those who are at risk of developing PD in the future, and to distinguish PD from related disorders. MIBG cardiac imaging is still considered an experimental procedure for detection of PD and is not yet in use as a clinical tool for this purpose.
A recent research study was conducted in monkeys in which the destruction of the sympathetic nerves of the heart was chemically induced to mimic the changes that are seen in PD. The cardiac system was then imaged using a number of new-generation radioactive tracers, which bind to markers of inflammation and oxidative stress. This model system may help to shed light on the molecular changes that accompany the loss of the sympathetic nerves of the heart and can also be used to track the response of the cardiac system to therapeutic agents.
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How Is Pneumonia Treated
Bacterial pneumonia can be treated with antibiotics usually by mouth. For more severe pneumonia, you may need to go to the hospital to be treated. Hospital treatment may include oxygen therapy to increase oxygen in the blood, intravenous antibiotics, and fluids. Pain relievers and medicine to reduce fever may also be given. With treatment, bacterial pneumonia usually begins to improve within 24-48 hours.
Viral pneumonia is usually less serious. A stay in the hospital is rarely needed. Antibiotics cannot be used to treat viral pneumonia, but may be given to fight a bacterial infection that is also present. Other drugs, such as those listed above, may be used to lessen symptoms. If you are given antibiotics, make sure you take all of the medicine, even if you feel better. If you stop taking the medicine too early, the infection can come back and may be harder to treat.
For both viral and bacterial pneumonia:
- Drink warm fluids to relieve coughing.
- Rest.
How To Get Palliative Care
If you or a loved one needs palliative care, ask your doctor for a referral.
Finding palliative care in your area is easy. Just go to our Palliative Care Provider Directory for a state-by-state list. To find out if palliative care is right for you, take our quiz.
Visit the American Heart Association for detailed patient and caregiver information on congestive heart failure: .
Visit the American Heart Associations Support Network to connect with others who have experienced congestive heart failure: .
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