Richard Lewis

3/2/24, 6 mins reading

Richard Lewis, an actor, and comedian, one of my favorite characters from the comedy show “ Curb Your Enthusiasm”, has recently passed away. he died from a heart attack based on news outlets.

Richard Lewis’ diagnosis of Parkinson’s disease.

Before his death, he was also diagnosed with Parkinson’s disease in 2021. As he stated on his Twitter that He “started walking a little stiffly” and was “shuffling” his feet. Since his diagnosis, he had “some occasional walking difficulties”, but was able to “get through it fine”.

Does Parkinson’s disease increase the risk of heart-related disorders?

As discussed in a previous blog on Parkinson’s disease and death, heart-related disorders are the major cause of Parkinson’s disease death. Roughly 30% of Parkinson’s disease patients die from Ischaemic heart and cardiovascular disease. Here is the question to ask: Does the heart attack (the cause of his death) originate from Parkinson’s disease? or another way to put it: does Parkinson’s disease increase the chance of patients developing Ischaemic heart and cardiovascular disease?

A short answer is: Yes. not only does Parkinson’s disease itself but also treatments of Parkinson’s disease increases the risk of heart disorders.

A recent review has summarized that 80% of Parkinson’s disease patients have cardiovascular disorders with orthostatic hypotension being the most common one. As part of non-motor symptoms of Parkinson’s disease, dysautonomia occurs when there's a malfunction in the autonomic nervous system, which includes both the sympathetic and parasympathetic nervous systems. In Parkinson’s disease patients, parasympathetic activity is decreased, while sympathetic activity is increased, the imbalance, as a result, will cause cardiac damage and dysfunction. Cardiac dysfunctions can be orthostatic hypotension, heart rate variability, and baroreflex dysfunction.

Parkinson’s disease medicines also increase the chance of PD patients developing heart disorders. As one of the most commonly used medicines, L-dopa decreases blood pressure and aggravates orthostatic hypotension as a result of a negative inotropic effect on the heart. Other medicines such as ergot-derived dopamine agonists(bromocriptine and cabergoline) have been found associated with heart failure.