مقالات پذیرفته شده در هشتمین کنگره بین المللی زیست پزشکی
Association of Coronary Artery Diseases and Parkinson's Disease in the Elderly: A Narrative Review
Association of Coronary Artery Diseases and Parkinson's Disease in the Elderly: A Narrative Review
Ahmadreza Kheradpishe,1,*
1. Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
Introduction: Parkinson's disease (PD) is a common neurodegenerative disorder in the elderly, characterized by motor symptoms such as tremor, bradykinesia, and rigidity, as well as non-motor symptoms like cognitive impairment and autonomic dysfunction. Coronary artery disease (CAD), resulting from atherosclerosis in the coronary arteries, is a leading cause of morbidity and mortality among older adults. Although PD and CAD are distinct conditions, recent studies suggest a potential association between them, particularly in the elderly population, where both conditions frequently coexist. The intersection of age-related changes, such as increased oxidative stress, inflammation, and comorbidities, may contribute to this association.
Methods: A comprehensive literature search was conducted using PubMed, Cochrane Library, and Scopus, focusing on studies published in the last 20 years. Search terms included "Parkinson's disease," "coronary artery disease," "elderly," "cardiovascular risk," "autonomic dysfunction," and "inflammation." Observational studies, cohort studies, case-control studies, and reviews were included to assess the association between CAD and PD specifically in the elderly population.
Results: Epidemiological studies indicate a higher prevalence of CAD in elderly patients with PD compared to those without PD, suggesting an interplay between the two conditions. Traditional cardiovascular risk factors, such as hypertension, diabetes mellitus, and dyslipidemia, are common in the elderly and contribute to the development of CAD. In elderly PD patients, additional factors such as autonomic dysfunction—leading to orthostatic hypotension and impaired heart rate variability—further increase cardiovascular risk. Reduced physical activity due to motor impairment in PD can exacerbate these risks, leading to accelerated atherosclerosis and CAD development. Furthermore, medications used to manage PD symptoms, such as dopamine agonists, have been associated with potential cardiovascular side effects, complicating the management of CAD in these patients.
Shared pathophysiological pathways may underpin the association between PD and CAD in the elderly. Both conditions are characterized by chronic systemic inflammation, with elevated levels of pro-inflammatory cytokines, such as TNF-α and interleukin-6, contributing to neurodegeneration and vascular damage. Oxidative stress, a key feature of aging, results in damage to both neuronal and vascular tissues, promoting the progression of both PD and CAD. Additionally, mitochondrial dysfunction, which plays a central role in PD pathogenesis, is also implicated in atherosclerosis, particularly in elderly patients with comorbidities such as diabetes. Genetic predispositions, including polymorphisms affecting lipid metabolism and inflammatory responses, may further link these diseases in older adults.
Conclusion: The coexistence of CAD and PD in the elderly involves a complex interaction of age-related risk factors, shared pathological processes, and the effects of PD-specific features such as autonomic dysfunction and medication use. While the current evidence suggests an increased prevalence of CAD among elderly patients with PD, further research is needed to clarify the causal relationship and understand the mechanisms involved. Prospective studies are essential to identify elderly patients with PD who are at high risk for CAD and to develop targeted interventions that can mitigate this risk. Clinicians should consider comprehensive cardiovascular risk assessments in elderly PD patients, accounting for both conventional and PD-specific risk factors. Improved understanding of the association between CAD and PD in this population could enhance patient care by allowing for more personalized and effective management strategies.