Vascular Comorbidities Among Patients with Multiple Sclerosis at a Comprehensive Care Center

Background: A progressive and potentially debilitating disease, multiple sclerosis (MS) often presents with various physical and cognitive impairments. Comorbidities in the MS population are important as they may contribute to MS disease progression, reduced quality of life, and unfavorable health outcomes. It is therefore relevant to estimate the prevalence of comorbid conditions in persons with MS (pwMS). Vascular comorbidities (Vcom) including; diabetes (DM), hypertension (HTN), high cholesterol (HCL), and stroke (CVI) are of significance in pwMS as these comorbidities have been shown to have an influence on increasing cognitive decline and brain atrophy. In addition, Vcom have been correlated with increased disability progression in MS. 

Objectives: To estimate the age-specific prevalence of Vcom in a community sample of multiple sclerosis patients (CSMS), and compare the rates to those of the general population (GP).

Methods: Retrospective chart review was carried out on 200 pwMS (CSMS) seen at a comprehensive care center. Inclusion criteria consisted of having an EDSS evaluation performed by a physician assistant between the time period of Oct 2011 and Jan 2013. Data collected by the physician assistant included patient demographics, disease history, and history of Vcom including DM, HTN,HCL, and CVI. Age-specific data for each of the Vcom were evaluated and compared to GP (CDC) data, stratified by gender. Data were analyzed using SPSS version 18. Because of small numbers of pwMS in our chart review over the age of 64, we focused on ages up to 74.  

Results: Participants in the CSMS (n=149 female; n=51 male) were between 17 and 80 years of age (M=44.9, SD=12.3), with a disease duration of 0 to 42 years (M=7.7, SD=9.3), and BMI between 18.9 and 54.3 (M=28.3, SD=6.8). Rates of Vcom in the CSMS (n=200) were similar to those in the GP. For women, rates of HTN: were lower for each age group (ag) (4.1% v. 8.7% and 25.0% v. 39.5% in the 20-44 and 45-64 ag, respectively); DM: in the 0-44 ag were higher for CSMS (4.1%) than the GP (1.7%); HCL: in the 45-64 ag were lower for CSMS (23.5%) than the GP (42.4%); other age-specific rates were similar.  Among men, differences between rates of HTN and HCL in the CSMS were similar to the GP.  Rates of DM in CSMS were somewhat lower than the GP for each ag. 

Conclusions: Among women and men, age-specific rates of vascular comorbidities in pwMS may be lower than or similar to rates in the general US population.