High risk of cardiovascular diseases after diagnosis of multiple sclerosis

Mult Scler. 2013 Sep;19(10):1336-40. doi: 10.1177/1352458513475833. Epub 2013 Jan 30.


Background: Studies of the risk of cardiovascular diseases (CVDs) in patients with multiple sclerosis (MS) have the potential to improve our understanding of the etiology of and the heterogeneity of prognosis and outcomes.

Objectives: To investigate the risk of myocardial infarction (MI), stroke, heart failure (HF), and atrial fibrillation (AF) or Flutter in MS patients with different ethnicity, both female and male.

Methods: Using Poisson regression, we performed a nationwide study in Sweden to investigate the association between the diagnosis of MS and the risk of MI, stroke, HF, or AF/Flutter in 8281 patients who were hospitalized due to MS from 1987 through 2009, plus 76,640 matched control individuals. We performed stratified analyses by sex, age at follow-up and country of birth.

Results: Among MS patients, the incidence rate ratio for MI was 1.85 (95% confidence interval (CI) 1.59 to 2.15), for stroke was 1.71 (95% CI 1.46 to 2.00), for HF was 1.97 (95% CI 1.52 to 2.56) and for AF/Flutter was 0.63 (95% CI 0.46 to 0.87), as compared with individuals without MS. The increased risks were particularly prominent for women. These associations remained after stratification by sex, age and country of birth.

Conclusion: We recommend careful surveillance and preventive CVDs measures among MS patients, particularly among the women.

Keywords: Multiple sclerosis; Sweden; atrial fibrillation; cardiovascular disease; epidemiology; ethnicity; flutter; heart failure; immigrants; myocardial infarction; risk factors; stroke.

MeSH terms

  • Adult
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / epidemiology*
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications*
  • Multiple Sclerosis / epidemiology
  • Risk Factors