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The Association Between MS and Coronary Artery Disease
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The MD Magazine Peer Exchange "Modifying the Course of Multiple Sclerosis in New Ways: The Latest Advances in Treatment" features a distinguished panel of physician experts discussing key topics in multiple sclerosis (MS) research and management, including the latest insights into MS pathophysiology, new medication options and their application in clinical practice, and more.
This Peer Exchange is moderated by Paul Doghramji, MD, who is a family physician at Pottstown Memorial Medical Center in Pottstown, PA, and medical director of Health Services at Ursinus College, in Collegeville, PA.
The panelists are:
- Fred D. Lublin, MD, FAAN, FANA, the Saunders Family Professor of Neurology and director of The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, and co-chief editor of Multiple Sclerosis and Related Disorders at the Icahn School of Medicine at Mount Sinai
- Patricia K. Coyle, MD, professor of neurology, vice chair of Clinical Affairs, and director of MS Comprehensive Care Center
- Suhayl Dhib-Jalbut, MD, professor and chief of the Department of Neurology at Rutgers, Robert Wood Johnson Medical School
Analysis of data from the Framingham Study revealed the existence of an association between multiple sclerosis and coronary artery disease.
Dr. Dhib-Jalbut said researchers looked at about 600 patients from the Framingham study who had multiple sclerosis and found a correlation between progression of disability and increased risk of coronary artery disease after controlling for other risk factors such as diabetes and high blood pressure.
In patients with cardiac disease, all of their organ systems are going to be at risk, including the central nervous system. The Framingham study was interesting because “the worse the cardiovascular health they actually found a correlation with greater disability in MS, and the cardiovascular health was worse in the more disabled, progressive MS cohort than in the relapsing cohort. So it’s really emphasizing the benefit of a wellness, health maintenance, vascular risk factor program, not just for cardiovascular health but things like diet, exercise, sleep, hygiene, not smoking, moderation,” Dr. Coyle said.
It is up to family physicians to monitor patients for cardiovascular risk factors and collaborate with neurologists to manage these symptoms while also treating the patient for MS.
“I can’t tell you how many patients with MS I see who neglected [other signs and symptoms] because they have MS; that’s the whole focus, and they don’t look at other things. The doctors don’t either,” Dr. Coyle remarked.
Many patients with multiple sclerosis who do not have any other serious health issues often turn to their neurologist as their primary physician. “They call us for everything,” said Dr. Lublin.
“So now, one of the things that we’re starting to do is pay attention to some of these other things to make sure that folks get screened for things like hemoglobin A1C and blood pressure. We have other reasons for looking at blood pressure too, including the MS medications we prescribe,” he said.
