Influence of arterial hypertension, type 2 diabetes and cardiovascular risk factors on ALS outcome: a population-based study

Amyotroph Lateral Scler Frontotemporal Degener. 2017 Nov;18(7-8):590-597. doi: 10.1080/21678421.2017.1336560. Epub 2017 Jun 15.


Objective: To assess the prognostic influence of pre-morbid type 2 diabetes mellitus, arterial hypertension and cardiovascular (CV) risk profile on ALS phenotype and outcome in a population-based cohort of Italian patients.

Methods: A total of 650 ALS patients from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid presence of type 2 diabetes mellitus, arterial hypertension was collected at the time of diagnosis. Patients' CV risk profile was calculated according to the Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice (JBS2).

Results: At the univariate analysis, the presence of pre-morbid arterial hypertension was associated with a higher age at onset of ALS and a shorter survival, and patients with a high CV risk profile had a worse prognosis than those with a low CV risk profile. The Cox multivariable analysis did not confirm such findings. Type 2 diabetes mellitus did not modify either the phenotype or the prognosis of ALS patients.

Conclusions: This study performed on a large population-based cohort of ALS patients has demonstrated that arterial hypertension, type 2 diabetes and CV risk factors, calculated using the Framingham equation, do not influence ALS phenotype and prognosis.

Keywords: Amyotrophic lateral sclerosis; arterial hypertension; cardiovascular risk factors; type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Amyotrophic Lateral Sclerosis / diagnosis
  • Amyotrophic Lateral Sclerosis / mortality*
  • Comorbidity
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / mortality*
  • Female
  • Heart Diseases / diagnosis
  • Heart Diseases / mortality*
  • Humans
  • Hypertension / diagnosis
  • Hypertension / mortality*
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Registries*
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Survival Analysis
  • Survival Rate