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LA MEDICACION DOPAMINERGICA PODRIA SER UTIL PARA TRATAR TRASTORNOS CARDIOVASCULARES

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Los pacientes con enfermedad de Parkinson presentan una reducción de los factores de riesgo vascular, atribuida a una desnervación simpática generalizada y a la estimulación central y periférica de los receptores D1/D2 por el tratamiento con L-dopa.
Autor:
Giulio Scigliano
Columnista Experto de SIIC

Institución:
Fondazione Istituto Nazionale Neurologico "C. Besta"

Artículos publicados por Giulio Scigliano
Coautores
Gabriele Ronchetti* Floriano Girotti* 
MD, Fondazione Istituto Nazionale Neurologico "C. Besta", Milán, Italia*
Recepción del artículo
16 de Marzo, 2009 		Aprobación
1 de Abril, 2009
Primera edición
9 de Octubre, 2009 		Segunda edición, ampliada y corregida
7 de Junio, 2021

LA MEDICACION DOPAMINERGICA PODRIA SER UTIL PARA TRATAR TRASTORNOS CARDIOVASCULARES

Resumen
Realizamos un estudio de casos y controles con 483 pacientes consecutivos con enfermedad de Parkinson idiopática (EP) y 533 controles apareados por edad y sexo con el fin de investigar la relación entre la EP y los factores de riesgo para enfermedades cardiovasculares. Mediante análisis multivariado, la diabetes, la hipertensión, los antecedentes de tabaquismo, colesterol elevado y altos niveles de triglicéridos fueron significativamente menos frecuentes en la EP que en los controles. Además, estas asociaciones resultaban más evidentes para los pacientes tratados con L-dopa. Interpretamos esta asociación entre EP y reducción de los factores de riesgo vascular como debidos a insuficiencia en el eje hipotalámico-hipofisario-suprarrenal, desnervación simpática generalizada en la EP y estimulación central o periférica de los receptores dopamínicos D1 y D2 por la L-dopa. Estos efectos cardiovasculares y metabólicos favorables sugieren que la medicación dopaminérgica puede resultar útil en el tratamiento de los trastornos cardiovasculares.

Palabras clave
enfermedad de Parkinson, diabetes, hipertensión, colesterol, triglicéridos


Artículo completo
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Extensión:  +/-9.72 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Diabetes, Hypertension, Cholesterol and Triglycerides in Parkinson's Disease

Abstract
We performed a case-control study on 483 consecutive patients with idiopathic Parkinson's disease (PD) and 533 age- and sex-matched controls to investigate the relationship between PD and risk factors for vascular diseases. Diabetes, high blood pressure, a history of cigarette smoking, high blood cholesterol, and high blood triglycerides were significantly less frequent in PD than in controls as studied by multivariable analysis. In addition, these associations were more evident for L-dopa-treated PD cases. We interpreted the association between PD and reduced risk factors for vascular disease as due to (a) impaired hypothalamic-pituitary-adrenal axis, (b) generalized sympathetic denervation in PD, and (c) central and peripheral stimulation of D1 and D2 dopamine receptors by L-dopa. These favorable metabolic and cardiovascular effects suggest that dopaminergic medication may be useful as therapy for cardiovascular disorders.

Key words
Parkinson disease, diabetes, hypertension, cholesterol, triglycerides


Full text
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Clasificación en siicsalud
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Especialidades
Principal: Neurología
Relacionadas: Atención Primaria, Bioquímica, Cardiología, Diabetología, Diagnóstico por Laboratorio, Geriatría, Medicina Interna



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Enviar correspondencia a:
Giulio Scigliano, Fondazione Istituto Nazionale Neurologico "C. Besta" Department of Neurology, 20127, Via Padova 113, Milán, Italia
Patrocinio y reconocimiento:
Agradecimiento: a Don Ward, por su ayuda con la redacción en inglés.
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