Vascular age seen higher than chronological age in MS patients
Difference more pronounced in those with cardiovascular diseases
People with multiple sclerosis (MS) show significant differences between actual age and vascular age, an indicator of heart and blood vessel health, even if they don’t have any cardiovascular disease, a study found.
The difference became more pronounced with the presence of additional cardiovascular diseases, reaching a peak among patients with high blood pressure, high levels of lipids (fats), and type 2 diabetes.
Factors such as body mass index (a measure of body fat), physical activity, and the presence of type 2 diabetes explained nearly one-quarter of the difference between a person’s chronological and vascular ages, suggesting that cardiovascular risk may be reduced with lifestyle modifications.
The study, “Investigation of differences between chronological and vascular age in persons with multiple sclerosis,” was published in PLOS One.
People with MS often have other co-occurring conditions, or comorbidities, and cardiovascular conditions are a leading cause of death in these patients. It’s estimated MS patients are nearly twice as likely to die from cardiovascular disease as the general population.
Vascular age
Vascular age is a concept that reflects a person’s cardiovascular health. It’s calculated based on factors such age, sex, total cholesterol levels, smoking status, and blood pressure. If an individual’s vascular age is higher than the person’s actual age, it suggests the person may be at higher risk for cardiovascular diseases.
A team of researchers in Serbia set out to assess the vascular ages of people with MS and how these differed from their actual ages. The study involved 274 patients who answered a questionnaire about demographics, clinical factors related to MS and cardiovascular issues, lifestyle habits such as physical activity and smoking status, and treatment. Blood samples were also collected to determine lipid levels.
Participants were divided into five groups, each with more cardiovascular conditions than the next. The first group consisted of patients without cardiovascular conditions. Groups 2-4 consisted of patients with high lipid levels (hyperlipidemia) only, those with hypertension and hyperlipidemia, and those with hyperlipidemia, hypertension, and type 2 diabetes. A fifth group involved MS patients with coronary artery disease, a type of heart disease where the arteries cannot deliver enough oxygen-rich blood to the heart muscles.
In general, patients in the first group were younger and more active, had lower total cholesterol levels and BMI, and had been living with MS for fewer years. However, age, BMI, cholesterol levels, and disease duration all tended to steadily increase in groups with more cardiovascular conditions, while the proportion of patients who were physically active decreased.
Results indicated that patients with hyperlipidemia, hypertension, and type 2 diabetes had the highest average vascular age (66.4), with a difference of 6.5 years from their chronological age. Conversely, those without cardiovascular conditions had only a minor difference (0.5 years).
People with coronary artery disease, considered to have more severe cardiovascular disease, did not show the highest vascular age or the most significant age difference. The researchers said that, due to their cardiovascular conditions, these patients may have changed their lifestyle substantially, which can modify their vascular age.
The researchers designed statistical models that could potentially explain the differences between age and vascular age. Their findings suggested that disability levels, BMI, physical activity, and the presence of type 2 diabetes may explain about 24% of the variation in the difference between chronological and vascular age.
“It is well-known that increased BMI, associated with low level of physical activity, leads to [a] chronic inflammation state which in turn promotes atherosclerosis [the buildup of plaque on artery walls that is linked with many cardiovascular diseases],” the researchers wrote. “Additionally, with disability progression, [people with MS] become less physically active and have greater chance for the development of obesity, the association with atherosclerosis being very well established.”
The researchers emphasized the importance of addressing cardiovascular health with lifestyle modifications and treatments, alongside MS management.
“Early diagnosis of MS together with immediate treatment with disease-modifying therapies, changes in lifestyle, and control of comorbidities may significantly contribute to brain health in this population and consequently to a slower disability progression and better MS outcome,” they wrote.
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