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Updated: Apr 16, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis
Natalie Kappus1, Bianca Weinstock-Guttman2, Jesper Hagemeier1
1Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.
Background:
Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS).
Objectives:
To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes.
Methods:
In a prospective study, 326 patients with relapsing-remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status.
Results:
Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p = 0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥ 2 CV risks (p = 0.003), while the frequency of ≥ 3 CV risks was 18.8% in the MS group and 8.6% in the HCs group (p = 0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes (p < 0.05), while overweight/obesity was associated with increased T1-LV (p < 0.39) and smoking with decreased whole brain volume (p = 0.049). Increased lateral ventricle volume was associated with heart disease (p = 0.029) in CIS.
Conclusions:
Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy.
Insights
Cardiovascular risks like smoking and hypertension are more common in multiple sclerosis (MS) patients. These risks correlate with increased lesion burden and brain atrophy in MS, impacting clinical outcomes.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Cardiovascular (CV) risk factors are linked to altered clinical outcomes in multiple sclerosis (MS) patients.
- Understanding the prevalence of CV risks in MS is crucial for managing disease progression.
Purpose of the Study:
- To determine the frequency of CV risk factors in patients with MS.
- To investigate the association between CV risks and MRI-derived brain changes in MS.
Main Methods:
- A prospective study included 326 relapsing-remitting MS, 163 progressive MS, 61 clinically isolated syndrome (CIS), and 175 healthy controls (HCs).
- CV risks (hypertension, heart disease, smoking, overweight/obesity, type 1 diabetes) were assessed.
- 3T MRI scans evaluated lesion volumes (LVs) and brain atrophy, with adjustments for covariates.
Main Results:
- MS patients exhibited higher rates of smoking (51.7% vs. 36.5%) and hypertension (33.9% vs. 24.7%) compared to HCs.
- Nearly 50% of MS patients had ≥ 2 CV risks, versus 36% of HCs.
- Hypertension and heart disease correlated with reduced grey matter and cortical volumes in MS. Smoking was linked to decreased whole brain volume.
Conclusions:
- Patients with MS and one or more CV risks demonstrate a greater lesion burden.
- Increased CV risks are associated with more advanced brain atrophy in multiple sclerosis patients.
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