title: Cardiovascular disease and diagnosis of amyotrophic lateral sclerosis: A population based study.
abstract: Amyotrophic lateral sclerosis (ALS) is a rapidly fatal neurodegenerative disease of unknown etiology. We investigated the association between ALS diagnosis and prior cardiovascular disease (CVD), and CVD-specific, hospital admissions in the Danish population. We conducted a population based nested case-control study, including 3182 Danish residents diagnosed with ALS at age ≥20 years (1982-2009) and 100 randomly selected controls for each case, matched on age, gender and vital status. We estimated odds ratios (OR) associated with CVD, and CVD-specific hospital admissions, adjusting for socioeconomic and marital status, region of residence and past diabetes and obesity diagnoses. The estimated adjusted OR for any CVD admission at least three years prior to the date of ALS diagnosis was 1.15 (95% CI 1.04-1.27). Our results varied across cause-specific admissions; for atherosclerosis the OR was 1.36 (95% CI 1.02-1.80) and for ischemic heart disease 1.14 (95% CI 0.99-1.31), while we observed no association with hypertensive and cerebrovascular diseases. Adjusting for or stratifying by COPD status, a cigarette-smoking correlate, did not change our results. In conclusion, in our population based study we found evidence for a moderately elevated association with CVD that was stronger for specific conditions, such as atherosclerosis. Our findings may have important implications for ALS pathogenesis.
authors.affiliation: a Departments of Environmental Health.
authors.forename: Marianthi-Anna
authors.initials: MA
authors.lastname: Kioumourtzoglou
authors.affiliation: b Epidemiology , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Seals
authors.affiliation: c National Rehabilitation Center for Neuromuscular Disorders , Copenhagen , and.
authors.forename: Ole
authors.initials: O
authors.lastname: Gredal
authors.affiliation: b Epidemiology , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA.
authors.forename: Murray A
authors.initials: MA
authors.lastname: Mittleman
authors.affiliation: d Danish Cancer Society Research Center , Copenhagen , Denmark.
authors.forename: Johnni
authors.initials: J
authors.lastname: Hansen
authors.affiliation: a Departments of Environmental Health.|b Epidemiology , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA.
authors.forename: Marc G
authors.initials: MG
authors.lastname: Weisskopf
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology*; D018672:Community Health Planning; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Amyotrophic lateral sclerosis (ALS); atherosclerosis; cardiovascular disease (CVD); ischemic heart disease