Depression, High BP Common In Patients with MS

Comorbid conditions are already reasonably common around the time of multiple sclerosis (MS) diagnosis, particularly depression, according to a new study.

“Further, all of the chronic conditions we evaluated except hyperlipidemia were more common among people with MS than people of the same age and sex from the general population–even 5 years before MS diagnosis,” said study lead author Ruth Ann Marrie, MD, PhD, of the department of internal medicine at the University of Manitoba.
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The researchers used population-based administrative health data from 4 Canadian provinces to identify 23382 incident MS cases and 116638 age-, sex-, and geographically matched controls. They estimated the prevalence of hypertension, diabetes, hyperlipidemia, heart disease, chronic lung disease, epilepsy, fibromyalgia, inflammatory bowel disease, depression, anxiety, bipolar disorder, and schizophrenia at MS diagnosis using validated case definitions and compared the populations using rate ratios.

Females made up 71.9% of the MS cases. Depression (19.1%) topped the list of most prevalent comorbidities. Compared to the matched population, all comorbidities except hyperlipidemia were more common in the MS population. Relative to the matched populations, the prevalence of hypertension was 16% higher for women with MS and 48% higher for men with MS, thus a disproportionately higher prevalence of hypertension in men with MS than women. Men with MS also had a disproportionately higher prevalence than women with MS for diabetes, epilepsy, depression, and anxiety.

“We did not expect so many of the sex-specific differences,” Marrie said. “Based on previous work, we thought that men might have a disproportionately higher prevalence of depression, but we did not expect to find this for diabetes, epilepsy, and anxiety as well. Sorting out why that is the case will require future research.”

She said this current study again emphasizes the high burden of depression and anxiety in MS (even before the diagnosis is conveyed), highlighting the need for identification and adequate treatment of these conditions.

“Comorbid conditions are common in MS even early in the disease course,” Marrie said. “Given other research showing that comorbidity in MS is associated with greater disability progression, and increased hospitalizations and mortality, identification and management of comorbid conditions is important from the very beginning in MS. This places a high premium on encouraging and supporting healthy behaviors–physical activity, healthy eating, quitting smoking–that can prevent and help treat some of these conditions.”

-Mike Bederka

Reference:

Marrie RA, Patten SB, Tremlett H, et al.; For the CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis. Sex differences in comorbidity at diagnosis of multiple sclerosis: A population-based study. Neurology. Published online before print March 9, 2016. doi:http://dx.doi.org/10.1212/WNL.0000000000002481