Contributions
Abstract: EP1448
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background and goals: Epidemiological findings suggest a relationship between MS clinical outcomes and several cardiovascular comorbidities, including obesity, insulin resistance, dyslipidemia, and hypertension; the latter being the most frequent cardiovascular comorbidity reported in MS. In chronic conditions, cardiovascular comorbidities are associated with decreased quality of life and increased mortality. In MS in particular, comorbidities are associated with delayed diagnosis and increased risk of disease progression. Despite the strong epidemiological evidence, there is a paucity of studies exploring pathophysiological mechanisms to explain the association between MS and cardiovascular comorbidities. In particular, the mechanisms linking MS severity and elevated blood pressure are poorly understood. Here, we aim to establish whether high blood pressure contributes to white-matter injury and brain atrophy in patients with relapsing-remitting multiple sclerosis (RRMS).
Methods: Estimates of cerebral fractional anisotropy, grey-matter volume and lesion load were obtained from 3-Tesla MRI in 95 patients with RRMS between December 2013 and July 2015. We used fractional anisotropy voxel-based statistics to establish the effect of blood pressure on white matter tracts. Additionally, we used voxel-based morphometry to study the effect on grey matter integrity. Finally we utilized linear models with log-transformed white matter lesion volume as the dependent variable and systolic blood pressure as the predictor to establish the effect of hypertension on lesion load.
Results: 57 female and 38 male patients (mean age 38.9 years, SD 10.5) underwent brain MRI. Only 29.5% had normal blood pressure levels, with 52.6% suffering from prehypertension and 17.9% with hypertension. Increasing systolic blood pressure was associated with damage to posterior white-matter tracts as well as greater levels of grey matter atrophy, in particular in the frontal cortex. Age-adjusted linear regression indicated that neither lesion volume (β=0.002, 95% CI -0.02 to 0.02; p=0.85) or lesion number (β=-0.004, 95% CI -0.03 to 0.02; p=0.74) were associated with systolic blood pressure.
Conclusions: Prehypertension and hypertension are frequent in MS patients. Increased blood pressure is related to white- and grey-matter integrity, both related to MS disability outcomes. These findings suggest attention to the control of blood pressure in MS patients.
Disclosure:
Daiana E. Dossi reports no disclosure.
Hernán Chaves reports no disclosure.
Evelyn S. Heck reports no disclosure.
Fernando Ventrice reports no disclosure.
Rohit Bakshi has received consulting fees from EMD Serono, Genentech, Sanofi-Genzyme, and Novartis and research support from Biogen, EMD-Serono, Novartis, and Sanofi-Genzyme.
Francisco J. Quintana serves on the editorial board for Systems Biomedicine, Inmunologia, American Journal of Clinical and Experimental Immunology, is an associate editor for Immunology (UK), is an advisory board member for Seminars in Immunopathology; received research support from Harvard Medical School, BADERC, NMSS
Jorge Correale is a board member of Merck-Serono Argentina, Novartis Argentina, Genzyme LATAM, Genzyme global, Biogen-Idec LATAM, and Merck-Serono LATAM. Dr. Correale has received reimbursement for developing educational presentations for Merck-Serono Argentina, Merck-Serono LATAM, Biogen-Idec Argentina, Genzyme Argentina, Novartis Argentina, Novartis LATAM, Novartis Global, and TEVA Argentina as well as professional travel/accommodations stipends.
Mauricio F. Farez has received travel accommodations from Teva, Merck-Serono, Biogen-Idec and Novartis. Dr. Farez has also received research funds from Biogen-Idec and Novartis Argentina.
Abstract: EP1448
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background and goals: Epidemiological findings suggest a relationship between MS clinical outcomes and several cardiovascular comorbidities, including obesity, insulin resistance, dyslipidemia, and hypertension; the latter being the most frequent cardiovascular comorbidity reported in MS. In chronic conditions, cardiovascular comorbidities are associated with decreased quality of life and increased mortality. In MS in particular, comorbidities are associated with delayed diagnosis and increased risk of disease progression. Despite the strong epidemiological evidence, there is a paucity of studies exploring pathophysiological mechanisms to explain the association between MS and cardiovascular comorbidities. In particular, the mechanisms linking MS severity and elevated blood pressure are poorly understood. Here, we aim to establish whether high blood pressure contributes to white-matter injury and brain atrophy in patients with relapsing-remitting multiple sclerosis (RRMS).
Methods: Estimates of cerebral fractional anisotropy, grey-matter volume and lesion load were obtained from 3-Tesla MRI in 95 patients with RRMS between December 2013 and July 2015. We used fractional anisotropy voxel-based statistics to establish the effect of blood pressure on white matter tracts. Additionally, we used voxel-based morphometry to study the effect on grey matter integrity. Finally we utilized linear models with log-transformed white matter lesion volume as the dependent variable and systolic blood pressure as the predictor to establish the effect of hypertension on lesion load.
Results: 57 female and 38 male patients (mean age 38.9 years, SD 10.5) underwent brain MRI. Only 29.5% had normal blood pressure levels, with 52.6% suffering from prehypertension and 17.9% with hypertension. Increasing systolic blood pressure was associated with damage to posterior white-matter tracts as well as greater levels of grey matter atrophy, in particular in the frontal cortex. Age-adjusted linear regression indicated that neither lesion volume (β=0.002, 95% CI -0.02 to 0.02; p=0.85) or lesion number (β=-0.004, 95% CI -0.03 to 0.02; p=0.74) were associated with systolic blood pressure.
Conclusions: Prehypertension and hypertension are frequent in MS patients. Increased blood pressure is related to white- and grey-matter integrity, both related to MS disability outcomes. These findings suggest attention to the control of blood pressure in MS patients.
Disclosure:
Daiana E. Dossi reports no disclosure.
Hernán Chaves reports no disclosure.
Evelyn S. Heck reports no disclosure.
Fernando Ventrice reports no disclosure.
Rohit Bakshi has received consulting fees from EMD Serono, Genentech, Sanofi-Genzyme, and Novartis and research support from Biogen, EMD-Serono, Novartis, and Sanofi-Genzyme.
Francisco J. Quintana serves on the editorial board for Systems Biomedicine, Inmunologia, American Journal of Clinical and Experimental Immunology, is an associate editor for Immunology (UK), is an advisory board member for Seminars in Immunopathology; received research support from Harvard Medical School, BADERC, NMSS
Jorge Correale is a board member of Merck-Serono Argentina, Novartis Argentina, Genzyme LATAM, Genzyme global, Biogen-Idec LATAM, and Merck-Serono LATAM. Dr. Correale has received reimbursement for developing educational presentations for Merck-Serono Argentina, Merck-Serono LATAM, Biogen-Idec Argentina, Genzyme Argentina, Novartis Argentina, Novartis LATAM, Novartis Global, and TEVA Argentina as well as professional travel/accommodations stipends.
Mauricio F. Farez has received travel accommodations from Teva, Merck-Serono, Biogen-Idec and Novartis. Dr. Farez has also received research funds from Biogen-Idec and Novartis Argentina.