Association between Parkinson's disease and cardiovascular disease mortality: A prospective population-based study from NHANES

Background and Aim : Previous studies have produced conflicting results on the association between Parkinson's disease (PD) and cardiovascular disease (CVD) mortality in different populations. Therefore, it is critical to examine the association between PD and CVD mortality specifically in the US population. Methods In this cohort investigation, we enrolled 28,242 participants from the NHANES spanning from 2003 to 2018. The 380 cases of PD in the cohort were identified by documenting "ANTIPARKINSON AGENTS" in their reported prescription medications. Mortality outcomes were ascertained by cross-referencing the cohort database with the National Death Index, which was last updated on 31 December 2019. Cardiovascular disease (CVD) mortality was categorised according to the 10th revision of the International Classification of Diseases using a spectrum of diagnostic codes. Weighted multivariable Cox regression analysis was used to examine the association between PD and the risk of CVD mortality. Results Among 28242 adults included in the study (mean age, 60.156 (12.55) years, 13766 men (48.74%) ), median follow-up period was 89 months. Individuals with PD had an adjusted HR of 1.82 (95% CI, 1.24–2.69; p = 0.002) for CVD mortality and 1.84 (95% CI, 1.44–2.33; p < 0.001) for all-cause mortality compared to those without PD. The association between PD and CVD mortality was robust in sensitivity analyses, after excluding participants who died within 2 years of follow-up and those with a history of cancer at baseline (HR,1.82 (95% CI, 1.20–2.75; p = 0.005). Conclusions Parkinson's disease was associated with a higher long-term CVD mortality rate in the US population.