Abstract Details

Title Hypertension Increases Risk of Ischemic Stroke in Multiple Sclerosis: Retrospective Analysis of a National Database

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-016

Objective The purpose of this study is to evaluate the interaction effect of hypertension and multiple sclerosis on ischemic stroke.

Background Multiple sclerosis (MS) is a chronic immune-mediated demyelinating disorder of central nervous system. Autoimmune diseases like multiple sclerosis are associated with elevated risk of ischemic stroke (IS). In our study, we want to find out whether the presence of a vascular risk factor such as hypertension increases the risk of IS in MS population.

Design/Methods Data was collected using the Cerner Healthfacts® database for the years 2000-2016. Patients with MS were identified using the ICD-9/10 codes. Multivariable logistic regression was used to assess the odds of IS with respect to MS while adjusting for gender, age, race, heart failure, coronary artery disease (CAD), atrial fibrillation, diabetes mellitus type-2 (DM2), smoking, peripheral vascular disease (PVD), alcohol, renal disease, liver disease, and hypertension. All the statistical analyses were performed using the SAS system (v9.4, Cary, NC, USA).

Results The contact prevalence of IS among MS patients was found to be 1.90% which is significantly higher (p<0.0001) than that among patients without MS (0.72%). In a multivariable modeling while adjusting for gender, race, age, heart failure, CAD, atrial fibrillation, DM2, smoking, PVD, alcohol, renal disease, and liver disease, it was found that both hypertension and MS are significant risk factors with effect modification for IS. In particular; (a) among non-hypertensive patients, MS subjects have 2.7 times higher odds of experiencing IS as compare to patients without MS (95% C.I. 2.177-3.282), (b) among patients with MS, hypertensive subjects have 3.42 times higher odds of experiencing IS as compared to non-hypertensive subjects (95% C.I. 2.966-3.936).

Conclusions Our study determines the presence of MS and hypertension as significant risk factors for developing IS. Our analysis shows that patients with MS have increased risk of IS in the presence of hypertension.

Authors/Disclosures
Asad Ikram, MD, MBBS PRESENTER	Dr. Ikram has nothing to disclose.
	No disclosure on file
Mudassir Farooqui, MD	Dr. Farooqui has nothing to disclose.
Sajid Suriya, MD	Dr. Suriya has nothing to disclose.
Maryam Zulfiqar, MD	Dr. Zulfiqar has nothing to disclose.
Dinesh V. Jillella, MD (Emory University School of Medicine / Grady Memorial Hospital)	Dr. Jillella has nothing to disclose.
	No disclosure on file
Corey C. Ford, MD, PhD, FAAN (University of New Mexico Health Sciences Center)	No disclosure on file
Michel T. Torbey, MD, MPH, FAAN (University of Oklahoma)	Dr. Torbey has nothing to disclose.
Atif Zafar, MD (St. Michael's Hospital (University of Toronto))	Dr. Zafar has nothing to disclose.

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