High blood pressure in multiple sclerosis seen to increase risk of disability progression

High blood pressure in multiple sclerosis seen to increase risk of disability progression

High blood pressure may be linked to greater overall disability in people with multiple sclerosis (MS), although the rate at which disability progresses might be slower than in patients without hypertension, a retrospective study concludes. The research, involving a large number of MS patients, helps to clarify a rather confusing range of views on how factors related to heart and metabolic disorders influence this disease’s course.

Studies investigating risk factors for disability progression in MS tend to come to rather different conclusions, as do those exploring risk factors for heart or metabolic disease (like obesity or diabetes) in relation to MS. In terms of hypertension, some studies report that MS patients develop high blood pressure at the same rate as other people, while others find high blood pressure is unusual in people with MS.

To get a clearer picture of how blood pressure might affect MS, and to identify potential links between heart and metabolic disease and MS, scientists at Chaim Sheba Medical Center and Tel Aviv University examined the medical records of 2,396 patients, most with relapsing-remitting disease.

The study, “Disability Progression in Multiple Sclerosis Is Affected by the Emergence of Comorbid Arterial Hypertension,“ published in the Journal of Clinical Neurology, used the Expanded Disability Status Scale (EDSS) for measuring disability, setting three values as measures of disease progression — EDSS scores of 4 (unaided walking and normal activities possible), 6 (assistance with walking needed), and 8 (bedridden, but use of arms).

Researchers also explored if patients had high blood pressure or a family history of hypertension, diabetes, or heart disease. In addition, they collect data about smoking habits.

Only 8.6% of patients studied had high blood pressure, but as a group they were more likely to progress in disability, with 62.3%, 51.2%, and 16.9% of them reaching EDSS 4, 6, and 8, respectively. Among patients without high blood pressure, the corresponding numbers were 43.2%, 27.9%, and 10.3%. The average time for disease progression to one of these three disability levels in all patients was, respectively, 123.5, 163.1, and 218.9 months.

Nevertheless, patients with high blood pressure took longer to progress between levels than those with normal pressure. On average, people with hypertension and MS took 51.6, 38.9, and 62.7 months longer to move to EDSS levels 4, 6, or 8, respectively, than those without elevated blood pressure who reached the same EDSS scores.

Smoking seemed to shorten the time for a patient to reach EDSS 4 and 8 disability levels (7.6 and 65.1 months earlier, respectively), while family history of heart and metabolic disease was not linked to progression.

Older age, in itself, is thought to be a risk factor for disease progression. The patients in this study were relatively young, with a mean age of 46.5, but taking age into account did not change the outcome of the analysis.

“Disability progression is more prevalent amongst hypertensive MS patients. However, they experience longer time intervals between the stages of disability progression,” the research team concluded.

By Magdalena Kegel

Multiple Sclerosis News Today

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The industry news information and articles are for informational purposes only, and are not intended to represent any trends, partnerships, commitments, or research of the Consortium of MS Centers or any of it's members in any way whatsoever, nor should any party be libel in any way to the reader or to any other person, firm or corporation reading this industry news section. Although the CMSC site includes links providing direct access to other Internet sites, CMSC takes no responsibility for the content or information contained on those other sites, and does not exert any editorial or other control over those other sites. CMSC is providing information and services on the Internet as a benefit and service in furtherance of CMSC's nonprofit and tax-exempt status. CMSC makes no representations about the suitability of this information and these services for any purpose.

Elizabeth Porco

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