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.

Key words:

• Amyotrophic lateral sclerosis (ALS)
• cardiovascular disease (CVD)
• ischemic heart disease
• atherosclerosis

Acknowledgements

This work was supported by the National Institute of Environmental Health Sciences [grant number R01 ES019188]. MAK and RS were supported in part by an NIH training grant [grant number T32 ES007069]. RS was also supported by the Taplin Fellowship.

Declaration of interest

The authors report no conflicts of interest.

Supplementary material for this article is available online