TABLE 3.
Risk of Parkinson’s disease by type of renin-angiotensin system inhibitors and central nervous system penetration (N = 62,228).
| Number of subjects a | Person-years | Number of events | Incidence rate b | Adjusted HR (95% Cl) c | |
|---|---|---|---|---|---|
| RAS inhibitor non-use | 31,114 | 237,332 | 596 | 2.51 | 1.00 (Reference) |
| Drug classification | |||||
| ACEI use | 11,897 | 88,225 | 173 | 1.96 | 0.91 (0.77–1.08) |
| ARB use | 28,589 | 223,033 | 441 | 1.98 | 0.74 (0.65–0.85) |
| BBB penetration | |||||
| Non-BBB-crossing | 23,805 | 185,832 | 363 | 1.95 | 0.89 (0.77–1.04) |
| BBB-crossing | 24,526 | 192,591 | 341 | 1.77 | 0.67 (0.57–0.78) |
| Drug classification and BBB penetration | |||||
| Non-BBB-crossing ACEI | 2,900 | 20,857 | 40 | 1.92 | 1.16 (0.84–1.60) |
| BBB-crossing ACEI | 9,936 | 74,036 | 148 | 2.00 | 0.93 (0.78–1.12) |
| Non-BBB-crossing ARB | 22,794 | 179,073 | 349 | 1.95 | 0.90 (0.77–1.05) |
| BBB-crossing ARB | 20,464 | 164,645 | 267 | 1.62 | 0.62 (0.53–0.74) |
ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor type 1 blocker; BBB, blood-brain barrier; cDDD, cumulative defined daily dose; CI, confidence.iInterval; DDD, defined daily dose; HR, hazard ratio.
a
The number of subjects in each category of drug type is not mutually exclusive, as the definition of each number of subjects was based on the population who used that drug at least once.
b
The incidence rate is presented per 1,000 person-years.
c
Adjusted for all covariates presented in Table 2 with a multivariate Cox proportional hazard model for Parkinson’s disease.