Differing trends in the incidence of vascular comorbidity in MS and the general population.
BACKGROUND
Although the adverse effects of vascular comorbidities are increasingly recognized in multiple sclerosis (MS), the epidemiology of these conditions remains poorly understood.


METHODS
Using population-based administrative data, we identified 44,452 Canadians with MS and 220,849 age-, sex- and geographically matched controls. We applied validated definitions to estimate the incidence of diabetes, hypertension, hyperlipidemia, and ischemic heart disease (IHD) from 1995 to 2005.


RESULTS
Of the MS cases, 31,757 (71.4%) were in female participants, with a mean (SD) age at the index date of 43.8 (13.7) years. Over time, the age-standardized incidence of diabetes rose more in the MS population (incidence rate ratio [IRR] per year 1.06; 95% confidence interval [CI] 1.03-1.08) than in the matched population (IRR per year 1.02; 95% CI 1.01-1.03). Temporal trends in the age-standardized incidence of hyperlipidemia, hypertension, and IHD were similar in both populations. Among those aged 20-44 years, the incidence of IHD was higher in the MS population (IRR 1.59; 95% CI 1.19-2.11). The increased incidence of IHD in the MS population was attenuated among those aged 60 years and older (IRR 1.01; 95% CI 0.97-1.06).


CONCLUSIONS
The incidence rates of diabetes, hypertension, and hyperlipidemia are rising within the MS population. Programs to systematically prevent and treat these conditions are needed.
Departments of Internal Medicine (RAM) and Community Health Sciences (RAM, JB), University of Manitoba, Winnipeg; Departments of Psychiatry and Medicine (JF), Dalhousie University, Halifax; Department of Medicine (Neurology) (HT), University of British Columbia, Vancouver; Department of Epidemiology and Biostatistics and Occupational Health (CW), McGill University, Montreal; Faculty of Rehabilitation Medicine (SW), University of Alberta, Edmonton; and Department of Community Health Sciences (SBP), University of Calgary, Canada.
Ruth Ann
RA
Marrie
Departments of Internal Medicine (RAM) and Community Health Sciences (RAM, JB), University of Manitoba, Winnipeg; Departments of Psychiatry and Medicine (JF), Dalhousie University, Halifax; Department of Medicine (Neurology) (HT), University of British Columbia, Vancouver; Department of Epidemiology and Biostatistics and Occupational Health (CW), McGill University, Montreal; Faculty of Rehabilitation Medicine (SW), University of Alberta, Edmonton; and Department of Community Health Sciences (SBP), University of Calgary, Canada.
John
J
Fisk
Departments of Internal Medicine (RAM) and Community Health Sciences (RAM, JB), University of Manitoba, Winnipeg; Departments of Psychiatry and Medicine (JF), Dalhousie University, Halifax; Department of Medicine (Neurology) (HT), University of British Columbia, Vancouver; Department of Epidemiology and Biostatistics and Occupational Health (CW), McGill University, Montreal; Faculty of Rehabilitation Medicine (SW), University of Alberta, Edmonton; and Department of Community Health Sciences (SBP), University of Calgary, Canada.
Helen
H
Tremlett
Departments of Internal Medicine (RAM) and Community Health Sciences (RAM, JB), University of Manitoba, Winnipeg; Departments of Psychiatry and Medicine (JF), Dalhousie University, Halifax; Department of Medicine (Neurology) (HT), University of British Columbia, Vancouver; Department of Epidemiology and Biostatistics and Occupational Health (CW), McGill University, Montreal; Faculty of Rehabilitation Medicine (SW), University of Alberta, Edmonton; and Department of Community Health Sciences (SBP), University of Calgary, Canada.
Christina
C
Wolfson
Departments of Internal Medicine (RAM) and Community Health Sciences (RAM, JB), University of Manitoba, Winnipeg; Departments of Psychiatry and Medicine (JF), Dalhousie University, Halifax; Department of Medicine (Neurology) (HT), University of British Columbia, Vancouver; Department of Epidemiology and Biostatistics and Occupational Health (CW), McGill University, Montreal; Faculty of Rehabilitation Medicine (SW), University of Alberta, Edmonton; and Department of Community Health Sciences (SBP), University of Calgary, Canada.
Sharon
S
Warren
Departments of Internal Medicine (RAM) and Community Health Sciences (RAM, JB), University of Manitoba, Winnipeg; Departments of Psychiatry and Medicine (JF), Dalhousie University, Halifax; Department of Medicine (Neurology) (HT), University of British Columbia, Vancouver; Department of Epidemiology and Biostatistics and Occupational Health (CW), McGill University, Montreal; Faculty of Rehabilitation Medicine (SW), University of Alberta, Edmonton; and Department of Community Health Sciences (SBP), University of Calgary, Canada.
James
J
Blanchard
Departments of Internal Medicine (RAM) and Community Health Sciences (RAM, JB), University of Manitoba, Winnipeg; Departments of Psychiatry and Medicine (JF), Dalhousie University, Halifax; Department of Medicine (Neurology) (HT), University of British Columbia, Vancouver; Department of Epidemiology and Biostatistics and Occupational Health (CW), McGill University, Montreal; Faculty of Rehabilitation Medicine (SW), University of Alberta, Edmonton; and Department of Community Health Sciences (SBP), University of Calgary, Canada.
Scott B
SB
Patten