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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.

Keywords

Multiple sclerosis hypertension Hispanic Latinx disability

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References

Conway

Thompson

Cohen

JA.

Influence of hypertension, diabetes, hyperlipidemia, and obstructive lung disease on multiple sclerosis disease course. Mult Scler 2017; 23(2): 277–285.

Marrie

Elliott

Marriott

, et al. Comorbidity increases the risk of hospitalizations in multiple sclerosis. Neurology 2015; 84(4): 350–358.

Al-Sakran

Marrie

Blackburn

, et al. Impact of comorbidity on hospitalizations in individuals newly diagnosed with multiple sclerosis: A longitudinal population-based study. Mult Scler Relat Disord 2020; 40: 101955.

Marrie

Horwitz

Cutter

, et al. Comorbidity delays diagnosis and increases disability at diagnosis in MS. Neurology 2009; 72(2): 117–124.

Marrie

Rudick

Horwitz

, et al. Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis. Neurology 2010; 74(13): 1041–1047.

Goldman

Min

Lobo

, et al. Retrospective cohort study of the relationship between systolic blood pressure variability and multiple sclerosis disability. BMJ Open 2020; 10(2): e034355.

Marrie

Leung

, et al. Rising prevalence of vascular comorbidities in multiple sclerosis: Validation of administrative definitions for diabetes, hypertension, and hyperlipidemia. Mult Scler 2012; 18(9): 1310–1319.

Marrie

Kosowan

Singer

Management of diabetes and hypertension in people with multiple sclerosis. Mult Scler Relat Disord 2020; 40: 101987.

Marrie

Reider

Cohen

, et al. A systematic review of the incidence and prevalence of cardiac, cerebrovascular, and peripheral vascular disease in multiple sclerosis. Mult Scler 2015; 21(3): 318–331.

10.

Marrie

Cohen

Stuve

, et al. A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: Overview. Mult Scler 2015; 21(3): 263–281.

11.

Ventura

Antezana

Bacon

, et al. Hispanic Americans and African Americans with multiple sclerosis have more severe disease course than Caucasian Americans. Mult Scler 2017; 23(11): 1554–1557.

12.

Amezcua

McCauley

JL.

Race and ethnicity on MS presentation and disease course. Mult Scler 2020; 26(5): 561–567.

13.

Redmond

Baer

Hicks

LS.

Health behaviors and racial disparity in blood pressure control in the national health and nutrition examination survey. Hypertension 2011; 57(3): 383–389.

14.

Sorlie

Allison

Avilés-Santa

, et al. Prevalence of hypertension, awareness, treatment, and control in the Hispanic Community Health Study/Study of Latinos. Am J Hypertens 2014; 27(6): 793–800.

15.

Egan

Zhao

Axon

RN.

US trends in prevalence, awareness, treatment, and control of hypertension 1988-2008. JAMA 2010; 303(20): 2043–2050.

16.

Marrie

Horwitz

Cutter

, et al. Cumulative impact of comorbidity on quality of life in MS. Acta Neurol Scand 2012; 125(3): 180–186.

17.

Thormann

Sørensen

Koch-Henriksen

, et al. Comorbidity in multiple sclerosis is associated with diagnostic delays and increased mortality. Neurology 2017; 89(16): 1668–1675.

18.

Whelton

Carey

Aronow

, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2018; 138(17): e426–e483.

19.

Amezcua

Beecham

Delgado

, et al. Native ancestry is associated with optic neuritis and age of onset in Hispanics with multiple sclerosis. Ann Clin Transl Neurol 2018; 5(11): 1362–1371.

20.

NIH policy on reporting race ethnicity data: Subjects in clinical research, 2001, https://grants.nih.gov/grants/guide/notice-files/not-od-01-053.html

21.

Kurtzke

JF.

Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 1983; 33(11): 1444–1452.

22.

Marrie

Horwitz

Cutter

, et al. Comorbidity, socioeconomic status and multiple sclerosis. Mult Scler 2008; 14(8): 1091–1098.

23.

Daviglus

Pirzada

Talavera

GA.

Cardiovascular disease risk factors in the Hispanic/Latino population: Lessons from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prog Cardiovasc Dis 2014; 57(3): 230–236.

24.

Bennett

Parto

Krim

SR.

Hypertension and ethnicity. Curr Opin Cardiol 2016; 31(4): 381–386.

25.

Amezcua

Conti

Liu

, et al. Place of birth, age of immigration, and disability in Hispanics with multiple sclerosis. Mult Scler Relat Disord 2015; 4(1): 25–30.

26.

Grim

Cowley

Jr Hamet

, et al. Hyperaldosteronism and hypertension: Ethnic differences. Hypertension 2005; 45(4): 766–772.

27.

Probst

Mowbray

Svensen

, et al. A systematic review of the impact of dietary sodium on autoimmunity and inflammation related to multiple sclerosis. Adv Nutr 2019; 10(5): 902–910.

28.

Castro

Waclawovsky

Marcadenti

Nutrition and physical activity on hypertension: Implication of current evidence and guidelines. Curr Hypertens Rev 2015; 11(2): 91–99.

29.

Charron

McKay

Tremlett

Physical activity and disability outcomes in multiple sclerosis: A systematic review (2011-2016). Mult Scler Relat Disord 2018; 20: 169–177.

30.

Thompson

Baranzini

Geurts

, et al. Multiple sclerosis. Lancet 2018; 391(10130): 1622–1636.

31.

Wang

Song

Fernandez-Escobar

, et al. The properties of cytokines in multiple sclerosis: Pros and cons. Am J Med Sci 2018; 356(6): 552–560.

32.

Guzik

Touyz

RM.

Oxidative stress, inflammation, and vascular aging in hypertension. Hypertension 2017; 70(4): 660–667.

33.

Stegbauer

Lee

Seubert

, et al. Role of the renin-angiotensin system in autoimmune inflammation of the central nervous system. Proc Natl Acad Sci U S A 2009; 106(35): 14942–14947.

34.

Platten

Youssef

Hur

, et al. Blocking angiotensin-converting enzyme induces potent regulatory T cells and modulates TH1- and TH17-mediated autoimmunity. Proc Natl Acad Sci U S A 2009; 106(35): 14948–14953.

35.

Kawajiri

Mogi

Higaki

, et al. Angiotensin-converting enzyme (ACE) and ACE2 levels in the cerebrospinal fluid of patients with multiple sclerosis. Mult Scler 2009; 15(2): 262–265.

36.

US. Hispanic Population Surpassed 60 million in 2019, but growth has slowed. Pew Research Center, 2020, https://www.pewresearch.org/fact-tank/2020/07/07/u-s-hispanic-population-surpassed-60-million-in-2019-but-growth-has-slowed/#:~:text=Between%202010%20and%202019%2C%20the,%2C%20behind%20white%20non%2DHispanics (accessed 7 July 2020).

37.

Key facts about the US. Latinos for national Hispanic heritage month. Pew Research Center, 2020, https://www.pewresearch.org/fact-tank/2020/09/10/key-facts-about-u-s-latinos-for-national-hispanic-heritage-month/

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Hypertension and hypertension severity in Hispanics/Latinx with MS

Abstract

Background:

Methods:

Results:

Conclusion:

Keywords

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References

Supplementary Material