Hypertension and hypertension severity in Hispanics/Latinx with MS

Abstract

Background: Vascular comorbidities (VCs) including hypertension (HTN) are associated with worse multiple sclerosis (MS) outcomes. HTN is common in Latinx, but the prevalence and relationship with disability are unknown in Latinx with MS. Methods: Latinx ( n = 451) from the Alliance for Research in Hispanic MS (ARHMS) seen between 2007 and 2019 were included. HTN, diabetes (DM), hyperlipidemia (HLD), ischemic events, and smoking were considered VC. Blood pressures (BPs) were classified using the American Heart Association (AHA) criteria. Logistic regression determined associations between VC and ambulatory disability accounting for age, sex, and disease duration. Results: Medical comorbidities were found in 41.9% and VC in 24.2%. Smoking (13.6%) and HTN (7.3%) were the most common. HTN was the most common over the age of 40 (12.6%). The odds of having severe disability were three times higher for those with HTN (odds ratio [OR], 3.12; 95% confidence interval (CI), 1.37–7.12). Stage II HTN according to AHA also tripled the odds (OR, 2.89; 95%CI, 1.11–7.55). AHA BP confirmed HTN in 27.5% (compared to 7.3% with established diagnosis). Conclusion: HTN diagnosis and stage II HTN defined by AHA were independently associated with severe ambulatory disability in Latinx with MS. HTN was underdiagnosed. Future studies should assess whether HTN treatment control would prevent disability in MS.

Increased Mortality Trends in Patients With Chronic Non-communicable Diseases and Comorbid Hypertension in the United States, 2000–2019

“…The upward trends in hypertension-related NCD mortality were in line with previously reported trends ( 11 , 12 , 21 ). This unexpected increase may be attributed to the increasing number of individuals with obesity ( 12 ), prolonged sedentary time due to electronic media ( 22 ), and extended disease duration of pre-existing NCDs ( 23 ). In addition, the wider variety of NCD-treating agents is a probable reason for this increasing trend.…”

Progressive Multiple Sclerosis

“…The recognition is growing that comorbidities may influence disease progression in MS 77 . Vascular comorbidity, whether present at symptom onset, diagnosis, or later in the disease course, has been associated with a substantially increased risk of disability progression in MS 77-82 …”

“…The recognition is growing that comorbidities may influence disease progression in MS. 77 Vascular comorbidity, whether present at symptom onset, diagnosis, or later in the disease course, has been associated with a substantially increased risk of disability progression in MS. [77][78][79][80][81][82] It is possible that vascular comorbidity augments neurodegeneration by adding greater accumulation of white matter lesions and/or a diffuse hypoperfusion with consequent chronic hypoxia. 82 Having type 2 diabetes, hypertension, dyslipidemia, or peripheral vascular disease has been reported to be associated with greater disability progression.…”

“…79 Recently, patients with MS with systolic blood pressure variability and greater blood pressure severity (stage II as staged by the American Heart Association) were found to have greater risk of MS-related disability. 80,81 More research is needed to determine the pathways in which having MS and vascular comorbidity interact. Beyond the current work focused on vascular comorbidities, additional studies around the impact of other comorbidities (eg, psychiatric comorbidities) and their impact on MS progression are needed.…”

“…A more granular look into vascular comorbidities suggests that arterial hypertension in patients with MS is associated with an increased risk of reaching higher levels of disability 79 . Recently, patients with MS with systolic blood pressure variability and greater blood pressure severity (stage II as staged by the American Heart Association) were found to have greater risk of MS-related disability 80,81 . More research is needed to determine the pathways in which having MS and vascular comorbidity interact.…”