Association of Vascular Risk Factors with the Risk of Parkinson’s Disease among Stroke Survivors—A Nationwide Population-Based Study
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Background
Stroke survivors usually have many vascular risk factors (VRFs), and recent studies have reported the association of VRFs with cognitive decline among stroke survivors, which are also associated with PD risk. Therefore, we aimed to investigate how VRFs influenced the risk of PD occurrence in individuals with stroke.
Methods
The Korean National Health Insurance Service database was used. We selected individuals who experienced new-onset stroke (ICD-10: I60-I64) between 2008 and 2016 and followed up until 2019. PD was diagnosed according to ICD-10 code G20 and rare and intractable disease registration code V124. Lifestyle factors were collected using self-reported questionnaires, and comorbidities were defined based on ICD-10 codes, medication, and laboratory and anthropometric findings. Cox proportional hazard analyses were conducted to evaluate the association of VRFs with PD incidence among stroke survivors.
Results
Among 284,799 stroke survivors, 3,274 cases of PD were reported over a median follow-up period of 5.04 years. In individuals with a history of stroke, smoking (former smoking, hazard ratio (HR) = 0.80, 95% confidence interval (CI), 0.72–0.88; current smoking, HR = 0.66, 95% CI, 0.58–0.76) and alcohol consumption (moderate drinking, HR = 0.83, 95% CI, 0.75–0.91; heavy drinking, HR = 0.74, 95% CI, 0.59–0.94) were associated with a decreased risk of PD. Physically active individuals who had a stroke showed a reduced trend for PD occurrence ( P = 0.0508). As for the association between comorbidities and the PD risk, the PD risk increased among stroke survivors with diabetes mellitus (P for trend <.001), particularly in those with a duration of diabetes mellitus of ≥5 years (HR = 1.38, 95% CI, 1.25–1.52).
Conclusions
Our results suggest that VRFs are associated with PD occurrence among stroke survivors. Understanding and managing VRFs in relation to PD risk is needed for disease management after stroke.
