A new systematic review and meta-analysis has revealed that individuals with multiple sclerosis (MS) demonstrate significantly compromised vascular function, particularly manifesting as increased arterial stiffness, compared to healthy individuals. The findings, published in Multiple Sclerosis and Related Disorders, underscore the need for enhanced understanding of vascular health management in MS patients.
Significant Vascular Differences Identified
The comprehensive analysis, led by Dr. Peixuan Zheng from the University of Illinois Chicago, examined data from 14 studies encompassing 614 MS patients, with women comprising 72% of the study population. The research revealed a medium effect of MS on vascular health, with a standardized mean difference (SMD) of 0.56 (95% CI, 0.08, 1.03; P = .02).
Particularly noteworthy was the significant difference in arterial stiffness between MS patients and controls (SMD 0.78; 95% CI, 0.21, 1.36; P = .008). "As arteries stiffen, their ability to buffer pulsatility diminishes, and thus imposes increased mechanical stress that can result in damage to target organs such as heart, brain, and kidney," the researchers explained.
Clinical Implications and Future Directions
The study's findings suggest that pathophysiological changes in MS may specifically impact arterial stiffness more prominently than other aspects of vascular health. Interestingly, common variables such as age, sex, body mass index, MS type, disease duration, disability level, and smoking status showed no significant moderating effects on vascular outcomes.
Despite hypertension being a common vascular comorbidity in MS, the analysis found no significant differences in mean resting brachial blood pressure between MS patients and control groups. This observation suggests that arterial stiffness might precede hypertension in MS, potentially contributing to disease progression and comorbidity development.
Recommendations for Clinical Practice
The research team advocates for a more comprehensive approach to vascular health assessment in MS patients. Beyond routine blood pressure measurements, clinicians should consider evaluating:
- Arterial stiffness
- Endothelial function
- Overall vascular health markers
These findings open new avenues for research into targeted interventions for improving vascular health in MS patients. The researchers emphasize that future studies should focus on developing evidence-based strategies for managing vascular complications in the MS population.
