Hypertension Is Associated With an Earlier Age of Onset of Huntington's Disease

• Published in: Movement disorders 2020-09, Vol.35 (9), p.1558-1564
• Main Authors: Schultz, Jordan L., Harshman, Lyndsay A., Langbehn, Douglas R., Nopoulos, Peg C.
• Format: Article
• Language: English
• Subjects: Adenine; Adult; Age; Age of Onset; Body mass index; Cytosine; Diagnosis; Enroll‐HD; Guanine; Humans; Huntington Disease - complications; Huntington Disease - epidemiology; Huntington Disease - genetics; Huntington's disease; Huntingtons disease; Hypertension; Hypertension - epidemiology; Movement Disorders; Neurodegenerative diseases; Proportional Hazards Models; symptom onset
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.28062

Background and Objective Hypertension (HTN) is associated with worsening clinical outcomes in neurodegenerative diseases. The relationship between HTN and the age of diagnosis (ADx) of Huntington's disease (HD) is not clear, however. This study sought to determine if the presence of HTN in adult patients with premanifest HD was associated with an earlier ADx compared with normotensive patients with HD. Methods Premanifest participants from Enroll‐HD were included if they had a cytosine‐adenine‐guanine greater than or equal to 36, baseline diagnostic confidence level less than 4, baseline total functional capacity score greater than 11, and baseline motor score less than 21. There were 3020 premanifest participants with HD, and 293 reported a diagnosis of HTN. HTN was transformed into a time‐dependent variable, and a Cox proportional hazard survival model determine if the presence of HTN affected the time to motor conversion. Baseline cytosine‐adenine‐guanine–age product score, cytosine‐adenine‐guanine repeat length, baseline age, sex, baseline body mass index, smoking history, and region were included as covariates. Results Participants with HTN had an increased annualized hazard of motor conversion compared to normotensive participants with HD (hazard ratio, 1.29; 95% confidence interval, 1.02–1.64; P = 0.034). Conclusions A previous study reported a protective effect of HTN in HD, but did not account for the fact that the prevalence of HTN increases with age. By controlling for this confounder, we more accurately outline the association between the ADx of HD to demonstrate that a diagnosis of HTN may be associated with an earlier ADx of HD. These results represent an association, however, and further investigation is warranted. © 2020 International Parkinson and Movement Disorder Society