Prevalence of hypertension and associated risk factors in people with long-term spinal cord injury living in the Netherlands

Abstract

Purpose: To describe the prevalence of hypertension and associated risk factors in people with long-term spinal cord injury (SCI) and to compare the prevalence of high blood pressure and/or the use of antihypertensive drugs with the prevalence in the Dutch general population.

Method: Multicentre cross-sectional study (N = 282). Hypertension was defined as a systolic blood pressure (SBP) of ≥140 mmHg and/or a diastolic blood pressure (DBP) of ≥90 mmHg after ≥2 blood pressure measurements during ≥2 doctor visits. High blood pressure was defined as a single measurement of a SBP of ≥140 mmHg and/or a DBP of ≥90 mmHg.

Results: The prevalence of hypertension was 21.5%. Significant predictors were: lesion level below C8 (T1–T6: OR =6.4, T7–L5: OR =10.1), history of hypercholesterolemia (OR =4.8), longer time since injury (OR =1.1), higher age (OR =1.1). The prevalence of high blood pressure and/or the use of antihypertensive drugs was higher in men (T1–T6 lesion: 48%; T7–L5 lesion: 57%) and women (T1–T6 lesion: 48%; T7–L5 lesion: 25%) with a SCI below C8 compared to Dutch able-bodied men (31%) and women (18%).

Conclusion: High blood pressure is common in people with SCI. Screening for hypertension during annual checkups is recommended, especially in those with a SCI below C8.

Implications for Rehabilitation

• High blood pressure is common in people with long-term SCI living in the Netherlands and its prevalence is higher in both men and women with a spinal cord lesion level below C8 compared with the age-matched Dutch general population.

• It is recommended to screen for hypertension during annual checkups in people with SCI, especially in those with a higher risk of developing hypertension, e.g. those with a spinal cord lesion level below C8 and an age of ≥45 years or a time since injury of ≥20 years.

• When a high blood pressure is measured in people with SCI, they should receive a further assessment of the blood pressure according to the available guidelines for the general population, including ambulatory 24 h-blood pressure monitoring.

Keywords:

• Blood pressure
• cardiovascular disease
• long-term care
• spinal cord injuries

Acknowledgements

We thank all ALLRISC research assistants and SCI rehabilitation physicians for collecting all the data and the following participating Dutch rehabilitation centers: Rehabilitation Center De Hoogstraat (Utrecht), Reade Center for Rehabilitation (Amsterdam); Rehabilitation Center Het Roessingh (Enschede); Adelante Rehabilitation Center (Hoensbroek); Sint Maartenskliniek (Nijmegen); University Medical Center Groningen, Center for Rehabilitation-location Beatrixoord (Haren); Rehabilitation Center Heliomare (Wijk aan Zee) and Rijndam Rehabilitation Center (Rotterdam).

Disclosure statement

The authors report no declarations of interest.

Funding information

ALLRISC is sponsored by “Fonds NutsOHRA” under the responsibility of the Netherlands. Organization for Health Research and Development (www.ZonMw.nl), Project number 89000006. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or any organization with which the authors are associated.