Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc
Journal website https://jnr.elmerpub.com

Original Article

Volume 15, Number 3, August 2025, pages 105-116

Neuroprotective Effects of Calcium Channel Blockers on Parkinson’s Disease Development: A Population Cohort Study

Figures

↓  Figure 1. Cohort definition flowchart for cohort 1 (CCB) and cohort 2 (BB). ACE: angiotensin-converting enzyme; BB: beta-blocker; CCB: calcium channel blocker.
Figure 1.
↓  Figure 2. Propensity score density function graphs showing cohort 1 (CCB) and cohort 2 (BB). BB: beta-blocker; CCB: calcium channel blocker. Figure 2.
↓  Figure 3. Kaplan-Meier survival graph comparing cohort 1 (CCB) vs. cohort 2 (BB). BB: beta-blocker; CCB: calcium channel blocker.
Figure 3.
↓  Figure 4. Cohort definition flowchart for cohort 3 (dihydropyridine) and cohort 4 (non-dihydropyridine).
Figure 4.
↓  Figure 5. Propensity score density function graphs showing cohort 3 (dihydropyridine) and cohort 4 (non-dihydropyridine).
Figure 5.
↓  Figure 6. Kaplan-Meier survival graph comparing cohort 3 (dihydropyridine) vs. cohort 4 (non-dihydropyridine).
Figure 6.
↓  Figure 7. Cohort definition with the participant numbers and inclusion and exclusion criteria for cohort 5 (amlodipine) vs. cohort 6 (nifedipine).
Figure 7.
↓  Figure 8. Propensity score density function graphs showing cohort 5 (amlodipine) and cohort 6 (nifedipine).
Figure 8.
↓  Figure 9. Kaplan-Meier survival graph comparing cohort 5 (amlodipine) vs. cohort 6 (nifedipine).
Figure 9.

Tables

↓  Table 1. Demographics of the Participants of Cohort 1 (CCB) and Cohort 2 (BB) Before and After Propensity Score Matching
 
Demographics Mean ± SD Patients % of cohort P-value Std diff.
BB: beta-blocker; CCB: calcium channel blocker; SD: standard deviation.
Cohort 1 (N = 385,522) and cohort 2 (N = 750,562) before propensity score matching
  Age at index < 0.001 0.099
    Cohort 1 59.6 ± 16.7 368,234 100%
    Cohort 2 61.2 ± 15.7 718,165 100%
  Female < 0.001 0.037
    Cohort 1 189,836 51.6%
    Cohort 2 356,797 49.7%
  Male 0.001 0.007
    Cohort 1 169,271 46.0%
    Cohort 2 332,589 46.3%
Cohort 1 (N = 364,898) and cohort 2 (N = 364,898) after propensity score matching
  Age at index 0.354 0.002
    Cohort 1 60.1 ± 16.0 364,898 100%
    Cohort 2 60.1 ± 15.9 364,898 100%
  Female 0.001 0.008
    Cohort 1 187,707 51.4%
    Cohort 2 189,173 51.8%
  Male 0.001 0.008
    Cohort 1 168,064 46.1%
    Cohort 2 166,602 45.7%

 

↓  Table 2. Racial Demographics of Participants in Cohort 1 (CCB)
 
Race Patients % of the cohort
White 195,442 53.69%
Black/African American 71,559 19.66%
Asian 27,086 7.44%
Native Hawaiian/other Pacific Islander 1,488 0.41%
American Indian/Alaska Native 784 0.22%
Other 13,023 3.63%
Unknown race 54,422 14.95%

 

↓  Table 3. Racial Demographics of Participants in Cohort 2 (BB)
 
Race Patients % of the cohort
White 500,955 69.81%
Black/African American 61,270 13.5%
Asian 31,371 4.37%
Native Hawaiian/other Pacific Islander 4,467 0.62%
American Indian/Alaska Native 1,592 0.22%
Other 13,023 3.63%
Unknown race 96,847 13.5%

 

↓  Table 4. Outcome Diagnosis as Parkinson Disease as Well as the Settings Under Which the Different Analyses Are Run
 
Outcome definition
Diagnosis (UMLS: ICD-10-CM: G20) Parkinson’s disease
Settings for the performed analyses
  Risk analysis Excluding patients with outcome prior to the time window
  Kaplan-Meier survival analysis Excluding patients with outcome prior to the time window
  Number of instances analysis Excluding patients with outcome prior to the time window. Excluding patients with zero outcomes. Counts are grouped by visit

 

↓  Table 5. Risk Analysis Comparing CCB (Cohort 1) vs. BB (Cohort 2 Which Is the Control)
 
Cohort Patients in cohort Patients with outcome Risk
Risk analysis excluding patients with outcome prior to the time window. BB: beta-blocker; CCB: calcium channel blocker; CI: confidence interval.
1 362,933 1,043 0.003
2 362,425 1,420 0.004
Risk analysis 95% CI
Risk difference -0.001 (-0.001 to -0.001)
Risk ratio 0.733 (0.677 - 0.794)
Odds ratio 0.733 (0.676 - 0.794)
Hazard ratio 0.776 (0.716 - 0.840)

 

↓  Table 6. Kaplan-Meier Survival Analysis Comparing Cohort 1 (CCB) vs. Cohort 2 (BB)
 
Cohort Patients in cohort Patients with outcome Median survival (days) Survival probability at end of time window
Kaplan-Meier survival analysis excluding patients with outcome prior to the time window. BB: beta-blocker; CCB: calcium channel blocker; CI: confidence interval.
1 362,933 1,043 - 96.86%
2 362,425 1,420 - 98.27%

 

↓  Table 7. Demographics of the Participants of Cohort 3 (Dihydropyridine) and Cohort 4 (Non-Dihydropyridine) Before and After Propensity Score Matching
 
Demographics Mean ± SD Patients % of cohort P-value Std diff.
SD: standard deviation.
Cohort 3 (N = 323,884) and cohort 4 (N = 63,745) before propensity score matching
  Age at index < 0.001 0.241
    Cohort 3 59.1 ± 16.4 310,581 100%
    Cohort 4 63.0 ± 16.5 60,212 100%
  Female < 0.001 0.091
    Cohort 3 157,695 50.8%
    Cohort 4 33,296 55.3%
  Male < 0.001 0.103
    Cohort 3 145,692 46.9%
    Cohort 4 25,182 41.8%
Cohort 3 (N = 60,212) and cohort 4 (N = 60,212) after propensity score matching
  Age at Index 0.994 < 0.001
    Cohort 3 63.0 ± 16.5 60,212 100%
    Cohort 4 63.0 ± 16.5 60,212 100%
  Female 1 < 0.001
    Cohort 3 33,296 55.3%
    Cohort 4 33,296 55.3%
  Male 0.991 < 0.001
    Cohort 3 25,184 41.8%
    Cohort 4 25,182 41.8%

 

↓  Table 8. Risk Analysis Numbers of Analysis Set 2 Which Included People Treated With Cohort 3 (Dihydropyridine) and Cohort 4 (Non-Dihydropyridine)
 
Cohort Patients in cohort Patients with outcome Risk
Risk analysis excluding patients with outcome prior to the time window. CI: confidence interval.
3 59,835 203 0.003
4 59,808 199 0.003
Risk analysis 95% CI
Risk difference 0.00006 (-0.001 to 0.001)
Risk ratio 1.020 (0.839 - 1.239)
Odds ratio 1.020 (0.838 - 1.240)
Hazard ratio 0.982 (0.808 - 1.194)

 

↓  Table 9. Kaplan-Meier Survival Analysis Comparing Cohort 3 (Dihydropyridine) vs. Cohort 4 (Non-Dihydropyridine)
 
Cohort Patients in cohort Patients with outcome Median survival (days) Survival probability at end of time window
Kaplan-Meier survival analysis excluding patients with outcome prior to the time window.
3 59,835 203 - 98.30%
4 59,808 199 - 98.69%

 

↓  Table 10. Demographics of the Participants of Cohort 5 (Amlodipine) and Cohort 6 (Nifedipine) Before and After Propensity Score Matching
 
Demographics Mean ± SD Patients % of cohort P-value Std diff.
Cohort 5 (N = 288,980) and cohort 6 (N = 19,882) before propensity score matching
  Age at index < 0.001 0.338
    Cohort 5 59.6 ± 15.8 277,109 100%
    Cohort 6 53.7 ± 19.1 18,918 100%
  Female < 0.001 0.310
    Cohort 5 137,633 49.7%
    Cohort 6 12,259 64.8%
  Male < 0.001 0.295
    Cohort 5 132,714 47.9%
    Cohort 6 6,347 33.6%
Cohort 5 (N = 18,918) and cohort 6 (N = 18,918) after propensity score matching
  Age at index 0.999 < 0.001
    Cohort 5 53.7 ± 19.1 18,918 100%
    Cohort 6 53.7 ± 19.1 18,918 100%
  Female 1 < 0.001
    Cohort 5 12,259 64.8%
    Cohort 6 12,259 64.8%
  Male 0.991 < 0.001
    Cohort 5 6,348 33.6%
    Cohort 6 6,347 33.6%

 

↓  Table 11. Risk Analysis Numbers of Analysis Set 2 Which Included People Treated With Cohort 5 (Amlodipine) vs. Cohort 6 (Nifedipine)
 
Cohort Patients in cohort Patients with outcome Risk
Risk analysis excluding patients with outcome prior to the time window. CI: confidence interval.
5 18,831 36 0.002
6 18,826 31 0.002
Risk analysis 95% CI
Risk difference 0.0003 (-0.001 to 0.001)
Risk ratio 1.161 (0.719 - 1.876)
Odds ratio 1.161 (0.718 - 1.878)
Hazard ratio 1.109 (0.686 - 1.793)

 

↓  Table 12. Kaplan-Meier Survival Analysis Comparing Cohort 5 (Amlodipine) vs. Cohort 6 (Nifedipine)
 
Cohort Patients in cohort Patients with outcome Median survival (days) Survival probability at end of time window
Kaplan-Meier survival analysis excluding patients with outcome prior to the time window.
5 18,831 36 - 99.71%
6 18,826 31 - 99.74%