Coronary artery disease and hypertension in a non-selected spinal cord injury patient population

Study design: Retrospective observational comparative study. Objectives: The objectives of this study were to assess the atherosclerosis diseases and risk factors prevalence after spinal cored injury (SCI). Setting: Loewenstein Rehabilitation Hospital, Israel. Methods: Data of 154 traumatic and non-traumatic SCI patients were retrospectively collected. Coronary artery disease (CAD), myocardial infarction (MI), hypertension (HT) and risk factors for atherosclerotic diseases were examined after SCI for prevalence and effects, and compared with published corresponding data of the general population. Results: CAD, MI and HT were found in 11.7, 6.7 and 29.2% of 120 patients, aged 53.4±11.1 years, 83.3% males, who survived until the end of the follow-up. Corresponding values for the general population, adjusted for age, gender and years of education, are 8.5, 6.6 and 24.9% in Israel, and 10.2% for CAD and 40.3% for HT, in US. Body mass index>30 increased the odds of acquiring CAD (P=0.016). Hypercholesterolemia and older age at injury increased the hazard for HT (P=0.044; P=0.019, respectively). A steady partner decreased the risk of CAD (P=0.029). HT was more prevalent at T₄ -T₆ than above T₄ (52 vs 23.3%, P=0.02). Patients with SCI below T₆ had a higher rate of diabetes mellitus, hypercholesterolemia, and past smoking, and fewer years of education than those with SCI above T₇ (P=0.016; P=0.032; P=0.034; P=0.014, respectively). Conclusion: The prevalence of CAD, HT and some of their risk factors after SCI is generally, but not consistently and not statistically significant, slightly higher than in the corresponding general population. The challenge is to reduce the prevalence of atherosclerotic morbidity after SCI below that in the general population.