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Published on: February 23, 2024
Atherosclerosis and multiple sclerosis: An overview on the prevalence of risk factors
Masoud Etemadifar1, Mehri Salari2, Ali Esnaashari3
1Professor of Neurology, Department of Neurosurgery, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Smoking is the most common atherosclerosis risk factor in people with multiple sclerosis (pwMS). Male sex and increasing age are linked to more risk factors in pwMS.
Area of Science:
- Neurology
- Cardiovascular Science
- Immunology
Background:
- Atherosclerosis, a leading cause of ischemic and coronary artery disease, is primarily immune-mediated.
- Prevalence data for vascular disease and atherosclerosis in people with multiple sclerosis (pwMS) is inconsistent.
- This study addresses the need for an overview of atherosclerotic risk factors in pwMS.
Purpose of the Study:
- To determine the prevalence of key atherosclerotic risk factors in people with multiple sclerosis (pwMS).
- To investigate the association between demographic factors and the number of risk factors in pwMS.
Main Methods:
- A cross-sectional study conducted over one year at the Isfahan MS center.
- Data collected from participant files and observer checklists.
- Included individuals with relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS); primary progressive MS (PPMS) cases were described separately.
Main Results:
- Tobacco smoking (18.4%) was the most prevalent risk factor, followed by dyslipidemia (10%), hypertension (8.8%), and diabetes mellitus (4.5%).
- In RRMS patients, prevalence was: smoking (17.4%), dyslipidemia (9.9%), hypertension (8.1%), and diabetes (4.3%).
- In SPMS patients, prevalence was: smoking (24.5%), hypertension (13.2%), dyslipidemia (9.4%), and diabetes (3.7%). Male sex and older age correlated with more risk factors.
Conclusions:
- Smoking is the most significant atherosclerosis risk factor identified in people with multiple sclerosis.
- Diabetes mellitus was the least common risk factor overall.
- Hypertension and dyslipidemia were the second and third most common factors, with hypertension being more prevalent than dyslipidemia in SPMS patients. Male sex and increasing age were associated with a higher burden of risk factors.
Background:
Atherosclerosis is the leading cause of ischemic heart disease and coronary artery disease. The process of atherosclerosis develops over a period of years and is mainly immune-mediated. Data regarding the prevalence of vascular disease and atherosclerosis among people with multiple sclerosis (pwMS) is inconsistent, therefore, we aimed to provide an overview of the prevalence of atherosclerotic risk factors in pwMS.
Methods:
This is a cross-sectional study over a period of one year among pwMS visiting the Isfahan MS center. Study data have been extracted using participants' files and a checklist that was completed by the observers. Only people with relapsing-remitting (RRMS) and secondary progressive (SPMS) forms of MS were included in the study. Participants with primary progressive (PPMS) disease are only described and have been excluded from analyses.
Results:
Of the 396 pwMS (343 with RRMS and 53 with SPMS), in descending order, the reported risk factors were tobacco smoking (18.4%), dyslipidemia (10%), hypertension (8.8%), and diabetes mellitus (4.5%). In people with RRMS, 17.4% were smokers, 9.9% had dyslipidemia, 8.1% had hypertension, and 4.3% had diabetes mellitus. In SPMS patients 24.5% reported a history of smoking, 13.2% had hypertension, 9.4% had dyslipidemia, and 3.7% had diabetes mellitus. Smoking was insignificantly associated with higher expanded disability status scale (Z: 1.70, p-value = 0.090). Male sex (RR [95%CI]: 1.628 [1.172, 2.261], p-value = 0.004) and increasing age (RR [95%CI]: 1.024 [1.008, 1.040], p-value = 0.003) were associated with a higher number of risk factors.
Conclusion:
The highest observed atherosclerosis risk factor among pwMS was smoking. Diabetes mellitus was the least reported risk factor in our population as a whole. Overall, and in participants with RRMS, dyslipidemia and hypertension were the second and third most commonly reported risk factors, however, hypertension exceeded dyslipidemia in participants with SPMS. Male sex and increasing age were associated with a higher number of atherosclerosis risk factors.
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