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Heart Disease and MS: Understanding the Connection

Posted on November 15, 2021
Medically reviewed by
Evelyn O. Berman, M.D.
Article written by
Anastasia Climan

While some researchers have linked multiple sclerosis (MS) to cardiovascular dysfunction, debate remains in the medical community: Are people with MS at a higher risk of heart disease?

Studies indicate that men with MS seem to experience heart disease at a similar rate as their peers without MS, whereas women with MS get certain cardiovascular issues at higher rates. This includes acute coronary syndrome (28 percent higher), cerebrovascular disease (59 percent higher), and macrovascular disease (32 percent higher). One study indicated that people with MS are 60 percent more likely to have a myocardial infarction (heart attack) than those in the general population.

Disability levels, less physical activity, higher depression rates, a higher incidence of smoking, and blood that’s more prone to clots are some of the suspected reasons for MS-related disparities in heart health.

Some members of MyMSTeam have reported emergency issues related to blood pressure. “I went to the ER,” one member wrote. “My blood pressure was 200/100. I saw the cardiologist for several tests. They put me on a new medication, and it’s hard to get used to.”

Other members of MyMSTeam have discussed having atrial fibrillation (an irregular heartbeat): “AFib runs rampant in my family,” one member said. “I had to have two valves replaced at 38. Because of the blood thinners, I can no longer take any MS drugs. Cardiac issues trump everything. But I’m still here!”

Since cardiovascular disease causes more deaths than any other health issue in the United States, people with MS should remain vigilant about healthy lifestyle habits and preventive care.

Causes and Risk Factors

Studies show that MS may lead to higher rates of certain types of cardiovascular disease. This could be due to the following contributing factors:

  • Altered cardiomyocite structure (abnormal muscle proteins in the heart that cause functional issues)
  • Chronic inflammation and more pro-inflammatory cytokines
  • Endothelial dysfunction leading to atherosclerosis and stiff arteries
  • Impaired autonomic nervous system function
  • Oxidative stress leading to elevations in LDL cholesterol
  • Reduced mobility that contributes to obesity and metabolic syndrome

Diabetes (another risk factor for cardiovascular disease) is rising disproportionately in the MS population. And while most research suggests that people with MS have hypertension (high blood pressure) at around the same rate as the general population, some members of MyMSTeam believe their medications have caused blood pressure spikes.

“I still have ringing in my ears, and my blood pressure is through the roof. Blood pressure is up because of my interferon,” one member wrote. Another member responded, “Yes, my blood pressure is way up from the interferon! I wonder what can be done other than getting off the meds.”

Ask your doctor if your MS medication raises your chances of high blood pressure or other cardiovascular risks. It’s never a bad idea to keep an eye on your blood pressure, especially when you’re trying out a new medication. While some people notice high blood pressure symptoms like double vision or headaches, hypertension often goes under the radar unless you check your blood pressure with a blood pressure cuff.

Since untreated MS poses a health risk in itself, your neurologist may encourage you to continue MS medications regardless of cardiovascular side effects. Let your health care provider know about any changes so they can help determine your best MS treatment options.

Living With MS and Heart Disease

Many of the recommendations used to slow the disease course of MS can also help ward off heart disease and other health concerns. Stress management, healthy eating (including plenty of anti-inflammatory omega-3 acids), and physical activity are some of the lifestyle factors that promote a better quality of life for people with MS and heart disease.

The American Heart Association advises 150 minutes per week of physical activity for adults. However, this guideline is only met by 20 percent of adults and teens in the general population. People with MS may experience exercise barriers, including mobility impairments, disability, and fatigue.

MyMSTeam members have shared different workout strategies, including water aerobics, modified exercise classes, and exercising on the couch or while laying down. Meeting with a physical therapist can help you find ways to stay active, maintain your independence, and protect your heart.

The relationship between MS and heart disease goes both ways. Studies show that high blood pressure and heart disease have adverse effects on the brain for people with MS. Individuals with MS and cardiovascular comorbidities (the presence of two or more diseases at the same time) appear to experience neurodegenerative tissue injury and brain atrophy. This research highlights the importance of addressing heart disease in people with MS.

Managing Heart Disease

Some lifestyle habits can help you better manage your heart health. Basic tips include:

  • Avoiding sedentary behavior by making an effort to move more throughout the day
  • Keeping up with dental cleanings and daily flossing and brushing
  • Quitting smoking and avoiding secondhand smoke
  • Sleeping for seven to eight hours per night
  • Avoiding saturated and trans fats in your diet

Your doctor may advise limiting your sodium intake to keep your blood pressure under control. If MS limits your ability to exercise, following a healthy diet can help you prevent excess weight gain that can raise your risk of heart disease. Focus on fresh fruits, vegetables, and high-fiber foods to promote satiety and keep your cholesterol levels down. Always talk to your health care team before changing your diet or starting a physical activity program.

Connect With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. Here, more than 175,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Are you living with MS and heart disease? What has helped you manage the two conditions? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.

Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Anastasia Climan is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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