Advertisement

Cardiovascular conditions in persons with multiple sclerosis, neuromyelitis optica and transverse myelitis

  • Paola Saroufim
    Affiliations
    Neuroimmunological Disorders Gene-Environment Epidemiology Laboratory, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States

    Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, United States
    Search for articles by this author
  • Sophia A. Zweig
    Affiliations
    Neuroimmunological Disorders Gene-Environment Epidemiology Laboratory, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
    Search for articles by this author
  • Devon S. Conway
    Affiliations
    The Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, United States
    Search for articles by this author
  • Farren B.S. Briggs
    Correspondence
    Corresponding author.
    Affiliations
    Neuroimmunological Disorders Gene-Environment Epidemiology Laboratory, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
    Search for articles by this author

      Highlights

      • Cardiovascular conditions in MS, NMOSD, and TM are as common as in unaffected individuals.
      • Individuals with MS had a higher burden of hypertension than control subjects.
      • Age of cardiovascular condition onset did not differ between demyelinating cases and control subjects.

      Abstract

      Background

      Cardiovascular conditions are associated with poorer outcomes in multiple sclerosis (MS). Whether the burden of cardiovascular conditions differs between those with demyelinating disease and unaffected controls is not clear. The objective of this study is to investigate the burden and age of onset of cardiovascular conditions in a US population with MS, neuromyelitis optica spectrum disorder (NMOSD), or transverse myelitis (TM) to unaffected controls adjusting for likely confounders.

      Methods

      Using a case-control study design, we compared the burden of self-reported diabetes mellitus type 2, heart disease, hyperlipidemia, and hypertension in cases with MS (N = 1,548), NMOSD (N = 306), and TM (N = 145) to controls (N = 677), adjusting for demographics, smoking history, obesity, family history of individual cardiovascular conditions, and presence of other cardiovascular conditions. The age of onset for individual cardiovascular conditions were also compared between cases and controls.

      Results

      MS cases were 48% more likely to have ever had hypertension than controls (p = 0.01). The prevalence of other cardiovascular conditions did not differ across cases and controls. There were also no differences in the age of cardiovascular disease onset between cases and controls.

      Conclusion

      Cardiovascular conditions are as common in those with demyelinating diseases compared to unaffected individuals, with hypertension being more common among those with MS.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Multiple Sclerosis and Related Disorders
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ajmera M.R.
        • Boscoe A.
        • Mauskopf J.
        • Candrilli S.D.
        • Levy M.
        Evaluation of comorbidities and health care resource use among patients with highly active neuromyelitis optica.
        J. Neurol. Sci. 2018; 384: 96-103
        • Baghbanian S.M.
        Follow-up of hypertension in patients with multiple sclerosis.
        Iran J. Neurol. 2016; 15: 180-181
        • Briggs F.B.
        • Acuna B.
        • Shen L.
        • Ramsay P.
        • Quach H.
        • Bernstein A.
        • Bellesis K.H.
        • Kockum I.S.
        • Hedstrom A.K.
        • Alfredsson L.
        • Olsson T.
        • Schaefer C.
        • Barcellos L.F.
        Smoking and risk of multiple sclerosis: evidence of modification by NAT1 variants.
        Epidemiol. 2014; 25: 605-614
        • Briggs F.B.
        • Acuna B.S.
        • Shen L.
        • Bellesis K.H.
        • Ramsay P.P.
        • Quach H.
        • Bernstein A.
        • Schaefer C.
        • Barcellos L.F.
        Adverse socioeconomic position during the life course is associated with multiple sclerosis.
        J. Epidemiol. Commun. Health. 2014; 68: 622-629
        • Capkun G.
        • Dahlke F.
        • Lahoz R.
        • Nordstrom B.
        • Tilson H.H.
        • Cutter G.
        • Bischof D.
        • Moore A.
        • Simeone J.
        • Fraeman K.
        • Bancken F.
        • Geissbuhler Y.
        • Wagner M.
        • Cohan S.
        Mortality and comorbidities in patients with multiple sclerosis compared with a population without multiple sclerosis: an observational study using the US department of defense administrative claims database.
        Mult. Scler. Relat. Disord. 2015; 4: 546-554
        • Conway D.S.
        • Thompson N.R.
        • Cohen J.A.
        Influence of hypertension, diabetes, hyperlipidemia, and obstructive lung disease on multiple sclerosis disease course.
        Multi. Sclero. 2016;
        • Hubbard E.A.
        • Motl R.W.
        • Fernhall B.
        Sedentary behavior and blood pressure in patients with multiple sclerosis.
        Int. J. M.S. Care. 2018; 20: 1-8
        • Jick S.S.
        • Li L.
        • Falcone G.J.
        • Vassilev Z.P.
        • Wallander M.A.
        Epidemiology of multiple sclerosis: results from a large observational study in the UK.
        J. Neurol. 2015; 262: 2033-2041
        • Jurynczyk M.
        • Craner M.
        • Palace J.
        Overlapping CNS inflammatory diseases: differentiating features of NMO and MS.
        J. Neurol. Neurosurg. Psychiatry. 2015; 86: 20-25
        • Marrie R.A.
        Comorbidity in multiple sclerosis: implications for patient care.
        Nature Rev. Neurol. 2017; 13: 375-382
        • Marrie R.A.
        • Cohen J.
        • Stuve O.
        • Trojano M.
        • Sorensen P.S.
        • Reingold S.
        • Cutter G.
        • Reider N.
        A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: overview.
        Multi. Sclero. 2015; 21: 263-281
        • Marrie R.A.
        • Horwitz R.
        • Cutter G.
        • Tyry T.
        Cumulative impact of comorbidity on quality of life in MS.
        Acta. Neurol. Scand. 2012; 125: 180-186
        • Marrie R.A.
        • Horwitz R.
        • Cutter G.
        • Tyry T.
        • Campagnolo D.
        • Vollmer T.
        Comorbidity delays diagnosis and increases disability at diagnosis in MS.
        Neurol. 2009; 72: 117-124
        • Marrie R.A.
        • Rudick R.
        • Horwitz R.
        • Cutter G.
        • Tyry T.
        • Campagnolo D.
        • Vollmer T.
        Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis.
        Neurol. 2010; 74: 1041-1047
        • Marrie R.A.
        • Yu B.N.
        • Leung S.
        • Elliott L.
        • Caetano P.
        • Warren S.
        • Wolfson C.
        • Patten S.B.
        • Svenson L.W.
        • Tremlett H.
        • Fisk J.
        • Blanchard J.F.
        • Epidemiology C.T.i.
        • Impact of Comorbidity on Multiple, S.
        Rising prevalence of vascular comorbidities in multiple sclerosis: validation of administrative definitions for diabetes, hypertension, and hyperlipidemia.
        Multi. Sclero. 2012; 18: 1310-1319
        • McKay K.A.
        • Jahanfar S.
        • Duggan T.
        • Tkachuk S.
        • Tremlett H.
        Factors associated with onset, relapses or progression in multiple sclerosis: a systematic review.
        Neurotoxicol. 2017; 61: 189-212
        • Mezei Z.
        • Olah L.
        • Kardos L.
        • Kovacs R.K.
        • Csiba L.
        • Csepany T.
        Cerebrovascular hemodynamic changes in multiple sclerosis patients during head-up tilt table test: effect of high-dose intravenous steroid treatment.
        J. Neurol. 2013; 260: 2335-2342
        • Moccia M.
        • Lanzillo R.
        • Palladino R.
        • Maniscalco G.T.
        • De Rosa A.
        • Russo C.
        • Massarelli M.
        • Carotenuto A.
        • Postiglione E.
        • Caporale O.
        • Triassi M.
        • Brescia Morra V.
        The Framingham cardiovascular risk score in multiple sclerosis.
        Eur. J. Neurol. 2015; 22: 1176-1183
        • Rosenberg G.A.
        Neurological diseases in relation to the blood-brain barrier.
        J. Cereb. Blood Flow Metab. 2012; 32: 1139-1151
        • Setiadi A.
        • Korim W.S.
        • Elsaafien K.
        • Yao S.T.
        The role of the blood-brain barrier in hypertension.
        Exp. Physiol. 2018; 103: 337-342
        • Simon K.C.
        • Schmidt H.
        • Loud S.
        • Ascherio A.
        Risk factors for multiple sclerosis, neuromyelitis optica and transverse myelitis.
        Multi. Sclero. 2015; 21: 703-709
        • Sternberg Z.
        Impaired neurovisceral integration of cardiovascular modulation contributes to multiple sclerosis morbidities.
        Mol. Neurobiol. 2017; 54: 362-374
        • Sternberg Z.
        • Leung C.
        • Sternberg D.
        • Li F.
        • Karmon Y.
        • Chadha K.
        • Levy E.
        The prevalence of the classical and non-classical cardiovascular risk factors in multiple sclerosis patients.
        CNS Neurol. Disord. Drug Targets. 2013; 12: 104-111
        • Sternberg Z.
        • Leung C.
        • Sternberg D.
        • Yu J.
        • Hojnacki D.
        Disease modifying therapies modulate cardiovascular risk factors in patients with multiple sclerosis.
        Cardiovasc. Ther. 2014; 32: 33-39
        • Thormann A.
        • Magyari M.
        • Koch-Henriksen N.
        • Laursen B.
        • Sorensen P.S.
        Vascular comorbidities in multiple sclerosis: a nationwide study from Denmark.
        J. Neurol. 2016;