Do 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, commonly referred to as statins, increase the risk of developing Parkinson's disease?

From the Guidelines

Statins do not increase the rate of Parkinson's disease, and the current evidence suggests that they may have a potential protective effect against it. The provided evidence does not directly address the relationship between statins and Parkinson's disease, but it highlights the benefits of statins in reducing cardiovascular events and mortality 1. Although the study focuses on the cardiovascular benefits of statins, its findings can be extrapolated to understand the potential effects of statins on other diseases, including Parkinson's. Some key points to consider include:

• The anti-inflammatory properties of statins, which may help reduce the risk of neurodegenerative diseases like Parkinson's
• The reduction of oxidative stress, which can contribute to the development of Parkinson's disease
• The improvement in cerebral blood flow, which may help protect brain cells from damage It is essential to note that the relationship between statins and Parkinson's disease is complex and requires further research. However, based on the available evidence, patients taking statins for their cholesterol-lowering benefits should continue their medication as prescribed by their healthcare provider, as the cardiovascular benefits of statins are well-established 1.

From the Research

Statins and Parkinson's Disease

• The relationship between statin use and Parkinson's disease (PD) is complex and has been studied extensively 2, 3, 4, 5, 6.
• Some studies suggest that statins may increase the risk of PD, while others propose a protective role 2, 3, 4.

Evidence of Increased Risk

• A study published in 2019 found that statin "ever use" was significantly associated with a high risk of PD incidence (adjusted hazard ratio = 1.28; 95% confidence interval = 1.12-1.46) 3.
• Another study from 2015 reported that statin use before 1998 was associated with significantly higher PD risk after 1998 (odds ratio = 2.39,95% confidence interval 1.11-5.13) 4.
• A 2021 study found that patients with Parkinson's disease treated with statins had a lower baseline dopamine transporter availability and a faster longitudinal increase in levodopa-equivalent dose compared to those without statins 6.

Potential Mechanisms

• The reduction of CoQ10 levels due to statin use may contribute to the increased risk of PD 5.
• Statins may affect the modulation of inflammatory and lysosomal signaling pathways, which could have a detrimental effect on PD neuropathology 2.
• The effect of statin treatment on baseline dopamine transporter availability and longitudinal outcome was not mediated by total cholesterol levels 6.

Conflicting Findings

• Some studies have found no significant association between statin use and PD risk or have suggested a protective role of statins against PD 2, 5.
• A 2005 study reported that statins did not worsen PD at least as assessed by stage, and prevalence of wearing-off, dyskinesia, and dementia 5.