Atherosclerosis and multiple sclerosis: An overview on the prevalence of risk factors

Abstract

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.