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Hypertension, antihypertensive use and the delayed onset of Huntington's Disease

Steventon, Jessica J., Rosser, Anne E., Hart, Emma and Murphy, Kevin 2020. Hypertension, antihypertensive use and the delayed onset of Huntington's Disease. Movement Disorders 35 (6) , pp. 937-946. 10.1002/mds.27976

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Abstract

Background: Hypertension is a modifiable cardiovascular risk factor implicated in neurodegeneration and dementia risk. In Huntington's disease, a monogenic neurodegenerative disease, autonomic and vascular abnormalities have been reported. This study's objective was to examine the relationship between hypertension and disease severity and progression in Huntington's disease. Methods: Using longitudinal data from the largest worldwide observational study of Huntington's disease (n = 14,534), we assessed the relationship between hypertension, disease severity, and rate of clinical progression in Huntington's disease mutation carriers. Propensity score matching was used to statistically match normotensive and hypertensive participants for age, sex, body mass index, ethnicity, and CAG length. Results: Huntington's disease patients had a lower prevalence of hypertension compared with age‐matched gene‐negative controls. Huntington's disease patients with hypertension had worse cognitive function, a higher depression score, and more marked motor progression over time compared with Huntington's disease patients without hypertension. However, hypertensive patients taking antihypertensive medication had less motor, cognitive, and functional impairment than Huntington's disease patients with untreated hypertension and a later age of clinical onset compared with untreated hypertensive patients and normotensive individuals with Huntington's disease. Conclusions: We report the novel finding that hypertension and antihypertensive medication use are associated with altered disease severity, progression, and clinical onset in patients with Huntington's disease. These findings have implications for the management of hypertension in Huntington's disease and suggest that prospective studies of the symptomatic or disease‐modifying potential of antihypertensives in neurodegenerative diseases are warranted.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Biosciences
Cardiff University Brain Research Imaging Centre (CUBRIC)
Medicine
Physics and Astronomy
Psychology
Publisher: Wiley
ISSN: 0885-3185
Funders: Wellcome Trust
Date of First Compliant Deposit: 28 November 2019
Date of Acceptance: 26 November 2019
Last Modified: 01 Jul 2020 11:13
URI: http://orca.cf.ac.uk/id/eprint/127231

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