The Connection Between Multiple Sclerosis and Atherosclerosis Risk

The Link Between Multiple Sclerosis and Atherosclerosis

Multiple sclerosis (MS) and atherosclerosis are two chronic inflammatory diseases that appear to have some connection according to recent research. MS is an autoimmune disease that affects the central nervous system, while atherosclerosis leads to hardening and narrowing of the arteries due to plaque buildup.

The Autoimmune and Inflammatory Link

Both MS and atherosclerosis involve inflammation as a key component of their disease processes. In MS, the immune system attacks the myelin sheaths that surround nerve fibers. This leads to damaged areas known as lesions or plaques that disrupt signals between the brain and body. In atherosclerosis, the inflammation occurs in the arterial walls due to buildup of fatty materials.

Some researchers now believe that systemic inflammation may be a key driver that connects these two diseases. Patients with one chronic inflammatory condition may be at increased risk for developing other inflammation-fueled disorders over time.

Shared Disease Processes

The inflammatory processes involved in MS and atherosclerosis share some similarities. Both involve an accumulation of plaque deposits, one in the nervous system and one in arterial walls and blood vessels. Some experts theorize that vascular factors associated with atherosclerosis could contribute to nervous system and myelin damage in MS.

Oxidative stress also occurs in both MS and atherosclerosis. This reflects an imbalance between damaging free radicals and protective antioxidants in the body. Ongoing oxidative damage to tissues and organs can result. Treatment to reduce inflammation and oxidative stress may benefit patients with both of these disorders.

Lifestyle Factors

Certain lifestyle factors like smoking, lack of exercise, and carrying excess weight may raise the risk for developing both MS and atherosclerosis. Such factors contribute to underlying inflammation and can accelerate the disease processes. Quitting smoking, staying active, and achieving a healthy body weight are all important for managing both conditions.

Increased Atherosclerosis Risk in MS Patients

A growing number of studies show that people with MS have an elevated risk of developing atherosclerosis and vascular diseases. Hardening of the arteries sets the stage for heart attacks, strokes, and other cardiovascular events. Researchers continue working to understand the nature of the MS-atherosclerosis link.

Evidence from Autopsy Studies

One line of compelling evidence comes from autopsy studies that compared blood vessels and arteries in people with MS to those without the disease. Across numerous studies spanning decades, pathological signs of atherosclerosis consistently appeared more severe in MS patients.

Finding more advanced atherosclerosis in people with MS after death provides evidence that vascular changes begin many years prior. This indicates that the process starts at younger ages in those with MS compared to the general population.

Increased Subclinical Vascular Disease

Researchers can now detect subclinical signs of atherosclerosis and cardiovascular disease using sensitive imaging tests. Studies using tests like coronary artery calcium scoring and carotid ultrasound reveal more plaque deposits and arterial changes in those with MS.

Even in patients with relatively young ages and free of any symptoms, early blood vessel damage shows up. This implies MS sets in motion inflammatory cascades that boost atherosclerosis progression faster than normal.

Higher Rates of Clinical Cardiovascular Outcomes

Along with having more atherosclerosis, researchers find worse cardiovascular outcomes among those living with MS. Analyses show higher rates of heart attacks, strokes, and cardiovascular deaths compared to the general public.

The risks appear elevated even after considering other compounding factors. This adds more confirmation that simply having MS nudges individuals toward faster cardiovascular injury in the long run.

Possible Explanations for the MS-Atherosclerosis Link

Uncovering an association between MS and accelerated atherosclerotic damage is the first step. Explaining the connection requires more work by scientists. Ongoing research continues examining explanations for why these diseases overlap so often.

Chronic Inflammation and Oxidative Stress

Systemic inflammatory pathways and excess reactive oxygen species likely contribute to the intersection of MS with early cardiovascular decline. But more research needs to clarify how underlying inflammation drives both sets of disease processes.

Chronic inflammation in MS sparks immune attacks on myelin in the central nervous system. Some experts suspect inflammatory signals get broadcast more widely, accelerating injury to blood vessels and vascular flow. More study is necessary to prove this mechanism.

Dysregulation of the Endothelium

Another explanation centers on endothelial dysfunction. The endothelium refers to the cell layer lining blood vessels and lymph passages. When working properly, endothelial cells regulate blood flow, prevent clotting, and control pressure.

In MS patients, endothelial dysfunction arises earlier and more severely. Dysfunctional endothelium drives faster atherosclerosis. Fixing impaired endothelial activity may help delay plaque buildup in arteries. This theory requires more validation moving forward.

Medications Used to Treat MS

Could the very drugs used to slow MS also increase cardiovascular risk? Some doctors now worry about potential side effects of certain disease-modifying therapies. More research must clarify if they inadvertently accelerate vascular problems.

For example, a few studies recently linked use of Alemtuzumab to higher rates of cardiovascular issues. Patients and doctors may need to weigh up benefits versus vascular risks when selecting MS treatment regimens.

Ways to Reduce Atherosclerosis Risk with MS

Despite some open questions about the mechanisms, clear evidence now demonstrates overlap between MS and accelerated atherosclerotic disease. Patients hoping to improve long-term health should work to minimize vascular damage.

Heart Healthy Lifestyle Choices

All MS patients should adhere to a heart healthy lifestyle for preventing atherosclerosis. This includes regular exercise, not smoking, limiting alcohol, eating a sound diet, and achieving a healthy body weight. Such positive lifestyle factors help counteract inflammation.

Vascular Testing

Since MS patients suffer vascular problems much earlier, getting tested makes sense. Ask your doctor about vascular screening tests to check for signs of atherosclerosis. Identifying issues early on allows for prevention efforts before heart attacks or strokes strike.

Medication Management

Work closely with your healthcare providers regarding medications used for treating MS or other conditions. Make sure to use drugs judiciously and monitor for potential side effects impacting cardiovascular health. Report any warning signs promptly.

Exploring newer agents that may restore endothelial function and reduce inflammation could provide benefits for both MS disease activity and vascular health over the long term. This requires input from doctors along with some trial-and-error.

The Takeaway

In recent decades, the recognition of excess cardiovascular risk among multiple sclerosis patients came to light through research. MS appears to accelerate inflammatory damage that speeds atherosclerosis development compared to healthy people.

Both MS and atherosclerosis share underlying disease mechanisms centered on inflammation, oxidative injury, and endothelial dysfunction. These likely help explain the intersection between nervous system and vascular damage.

All patients coping with MS must now consider the implications of heightened cardiovascular risk as part of comprehensive care. Working closely with medical teams to control inflammation, get tested for vascular changes, and minimize lifestyle factors allows for improving long-term health despite MS.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.