Effect of angiotensin II type 1-receptor blocker candesartan on hypertensive Parkinson's disease

Angiotensin II receptor blocker (ARB) therapy has been proven to be well tolerated and effective in the management of hypertension, chronic heart failure with left ventricular dysfunction, and the prevention and progression of diabetic renal disease. ARB also shows various effects other than a depression effect. We investigated the effect of candesartan cilexetil, one of a number of angiotensin II receptor blockers (ARB) on Parkinsonian symptoms as well as mental symptoms in patients with hypertensive PD. We assessed Parkinsonian symptoms as well as mental function by UPDRS, PDQ'39, SDS, HAD, and SUBI. HAD'anxiety scores, total scores of UPDRS (parts 1' 4), and scores of PDQ'39 were significantly decreased 6M after the therapy (p<0.05). Although little is known about the effect of the ARB on dopaminergic neurons, there is also a possibility of a placebo effect that plays an important role in the development of Parkinsonism. Alternatively, candesartan may reduce mental disorders associated with hypertension. Further studies are required to investigate the effect of ARB on motor or mental symptoms of Parkinson’s disease.