Tag: Multiple Sclerosis

Understanding Vascular Risks in People with Multiple Sclerosis (MS)

Multiple sclerosis (MS) is a complex neurological condition that affects the central nervous system. While much of the focus on MS is often on the symptoms related to the nervous system, recent research has shed light on another important aspect: the increased risk of vascular diseases, such as diabetes and hypertension, in people living with MS (PwMS). Let’s take a closer look at what this means and how it impacts overall health based on the findings of a recent paper from my team published in the Multiple Sclerosis Journal.

What the Research Shows

A large study conducted between 1987 and 2018 looked at the health records of over 12,000 people with MS and compared them with over 70,000 individuals without MS. The findings were significant:

  • Increased Risk of Diabetes: People living with MS have a higher risk of developing type 2 diabetes after being diagnosed with MS. Over 10 years, the incidence rate of diabetes was notably higher in people with MS compared to those without. Women with MS, in particular, showed an 18% higher rate of developing diabetes than the general population.
  • Hypertension Management: People living with MS were more likely to start treatments for hypertension (high blood pressure) compared to individuals without MS. Encouragingly, those with MS who started treatment for hypertension were also more likely to meet blood pressure management targets, as set by the National Institute for Health and Care Excellence (NICE).

However, despite better management, the overall burden of vascular diseases in people living with MS  remains higher than in the general population.

Why Is This Important?

People living with MS are already dealing with a condition that affects mobility, cognitive function, and quality of life. Adding the risk of cardiovascular diseases like diabetes and hypertension can worsen these issues, as vascular health plays a key role in overall well-being. Managing vascular risk factors is essential because conditions like high blood pressure or diabetes can lead to more frequent MS relapses, quicker disability progression, and lower quality of life.

Addressing the Risks

The good news from the study is that people living with MS are more likely to receive treatment for vascular conditions post-diagnosis. This reflects a positive shift in the healthcare approach to managing these risks. But there is still much work to be done. Vascular disease management in people with MS needs to be tailored to their specific needs, potentially requiring more stringent treatment targets to prevent further health complications.

What You Can Do

If you or someone you care about is living with MS, it’s essential to keep an eye on vascular health. Here are some practical steps:

  1. Regular Check-Ups: Make sure to have regular check-ups with your healthcare provider to monitor blood pressure, blood sugar levels, and cholesterol.
  2. Healthy Lifestyle Choices: Focus on a healthy diet, regular physical activity, and avoiding smoking, all of which can reduce the risk of vascular diseases.
  3. Medication Management: If you’re prescribed medications for conditions like hypertension or diabetes, make sure to follow the treatment plan closely and keep an open line of communication with your doctor about any side effects or concerns.
  4. Stay Informed: Understanding how MS interacts with other health conditions helps you stay ahead. Don’t hesitate to ask your healthcare provider about any concerns related to cardiovascular health.

Final Thoughts

The relationship between MS and vascular diseases is complex, but this research highlights the importance of proactive care. By focusing on managing vascular risk factors, people living with MS  can work toward reducing the additional health burdens that come with the disease, improving their long-term health and quality of life.

This study reminds us that while MS presents many challenges, there are steps we can take to mitigate its impacts, especially when it comes to vascular health. Stay engaged with your healthcare team and prioritise comprehensive care to address both neurological and cardiovascular health.

Having multiple sclerosis and depression is associated with an increased risk of early death

Depression is common in people with multiple sclerosis (MS), and a new study from our research group shows that people with both conditions are more likely to die over the next decade than people with just one or neither condition. The study was published in the September 2021, online issue of Neurology, the medical journal of the American Academy of Neurology. The study also found that people with MS and depression have an increased risk of developing vascular disease such as heart attack and stroke.

“These findings underscore the importance of identifying depression in people with MS as well as monitoring for other risk factors for heart disease and stroke,” said lead author Raffaele Palladino, MD, PhD, of Imperial College of London in the United Kingdom. “Future studies need to be conducted to look at whether treating depression in people with MS could reduce the risk of vascular disease as well as death over time.”

The study involved 12,251 people with MS and 72,572 people who did not have MS. We looked at medical records to see who developed vascular disease or died over a period of 10 years. At the start of the study, 21% of the people with MS had depression and 9% of the people without MS had depression.

We found that people with both MS and depression had a mortality rate from any cause of 10.3 per 100,000 person-years. Person-years take into account the number of people in a study as well as the amount of time spent in the study. The mortality rate for people with MS without depression was 10.6, for people who had depression without MS it was 3.6 and for people with neither condition it was 2.5.

Once we adjusted for other factors that could affect the risk of death such as smoking and diabetes, we found that people with both conditions were more than five times more likely to die during the next decade than people with neither condition. People with MS without depression were nearly four times more likely to die than people with neither condition and people with depression without MS were nearly twice as likely to die.

For the risk of vascular disease, the rate for people with both MS and depression was 2.4 cases per 100,000 person-years; 1.2 for people with MS without depression; 1.3 for people with depression without MS; and 0.7 for people with neither condition.

After adjusting for other factors, we found that people with both conditions were more than three times as likely to develop vascular disease as people with neither condition.

“When we looked at the risk of death, we found that the joint effect of MS plus depression equaled more than the effect for each individual factor alone — in other words, the two conditions had a synergistic effect,” Palladino said. “A total of 14% of the effect on mortality rate could be attributed to the interaction between these two conditions.”

Materials for this blog were provided by the American Academy of Neurology.

Journal Reference:

  1. Raffaele Palladino, Jeremy Chataway, Azeem Majeed, Ruth Ann Marrie. Interface of Multiple Sclerosis, Depression, Vascular Disease, and Mortality: A Population-Based Matched Cohort Study. Neurology, 2021; 10.1212/WNL.0000000000012610 DOI: 10.1212/WNL.0000000000012610