Multiple sclerosis (MS) and cardiovascular health are linked in several important and complex ways, influencing both the risk and progression of MS as well as overall cardiovascular outcomes. Understanding this connection involves looking at how vascular health impacts MS onset, progression, and disability, and how MS itself may increase the risk of cardiovascular disease.
MS is a chronic neurological condition characterized by inflammation and damage to the myelin sheath, the protective covering of nerve fibers in the brain and spinal cord. This damage disrupts nerve signals, leading to symptoms like muscle weakness, coordination problems, and cognitive difficulties. While MS primarily affects the nervous system, research increasingly shows that vascular health—how well blood vessels function and how blood circulates—plays a significant role in the disease.
People with MS tend to have a slightly higher risk of cardiovascular disease compared to the general population. This includes conditions such as heart attacks, strokes, hypertension (high blood pressure), and peripheral vascular disease. Cardiovascular disease is also a leading cause of death among people with MS, highlighting the importance of cardiovascular health management in this group.
One reason for this increased risk is that vascular comorbidities—other health problems related to blood vessels—are common in people with MS. Conditions like type 2 diabetes, high cholesterol, and hypertension not only occur frequently but may also worsen MS progression and disability. For example, having diabetes or high blood pressure at any point during the course of MS is associated with faster disability progression. This suggests that poor cardiovascular health can exacerbate the neurological damage caused by MS.
The relationship between MS and cardiovascular health is bidirectional. On one hand, vascular risk factors may contribute to the onset or worsening of MS. For instance, a high body mass index (BMI) during childhood or adolescence is linked to an increased risk of developing MS later in life. On the other hand, MS-related inflammation and reduced mobility can increase cardiovascular risk. Inflammation in MS may affect blood vessels, promoting atherosclerosis (hardening of the arteries), while reduced physical activity due to MS symptoms can lead to poorer cardiovascular fitness and increased risk factors like obesity and high cholesterol.
Vitamin D status is another important factor connecting MS and cardiovascular health. Vitamin D deficiency is common in people with MS and is known to increase cardiovascular disease risk in the general population. Low vitamin D levels in people with MS have been linked to worse cardiovascular outcomes, including higher rates of heart attacks and strokes. Supplementing vitamin D may help reduce these risks, although more research is needed to confirm the benefits specifically for people with MS.
Exercise plays a crucial role in managing both MS and cardiovascular health. Regular physical activity helps reduce inflammation, improve blood flow, and maintain brain health by preserving the microstructure of neurons and myelin. Exercise also supports cardiovascular function by improving heart health, lowering blood pressure, and managing cholesterol levels. For people with MS, exercise can improve muscle strength, flexibility, mood, and overall quality of life, while also reducing the risk of cardiovascular disease.
Healthy lifestyle habits are essential for people with MS to protect their cardiovascular health. These include eating a balanced diet rich in fruits, vegetables, and whole grains; avoiding smoking; limiting alcohol consumption; managing stress; and ensuring regular medical screenings for blood pressure and cholesterol. Stress and emotional factors like anger and anxiety, which can be more common in chronic illness, also contribute to cardiovascular risk and should be addressed through appropriate support and interventions.
In summary, the link between MS and cardiovascular health is multifaceted. Vascular comorbidities can increase the risk of developing MS and worsen its progression, while MS itself can raise the risk of cardiovascular disease through inflammation and reduced physical activity. Maintaining cardiovascular health through lifestyle choices, medical management, and exercise is vital for people with MS to reduce disability progression and improve overall outcomes.
