Influence of arterial hypertension, type 2 diabetes and cardiovascular risk factors on ALS outcome: a population-based study

Abstract

Objective: To assess the prognostic influence of pre-morbid type 2 diabetes mellitus, arterial hypertension and cardiovascular (CV) risk profile on ALS phenotype and outcome in a population-based cohort of Italian patients. Methods: A total of 650 ALS patients from the Piemonte/Valle d’Aosta Register for ALS, incident in the 2007–2011 period, were recruited. Information about premorbid presence of type 2 diabetes mellitus, arterial hypertension was collected at the time of diagnosis. Patients’ CV risk profile was calculated according to the Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice (JBS2). Results: At the univariate analysis, the presence of pre-morbid arterial hypertension was associated with a higher age at onset of ALS and a shorter survival, and patients with a high CV risk profile had a worse prognosis than those with a low CV risk profile. The Cox multivariable analysis did not confirm such findings. Type 2 diabetes mellitus did not modify either the phenotype or the prognosis of ALS patients. Conclusions: This study performed on a large population-based cohort of ALS patients has demonstrated that arterial hypertension, type 2 diabetes and CV risk factors, calculated using the Framingham equation, do not influence ALS phenotype and prognosis.

Keywords:

• Amyotrophic lateral sclerosis
• cardiovascular risk factors
• type 2 diabetes mellitus
• arterial hypertension

Acknowledgements

This work was in part supported by the Italian Ministry of Health (Ministero della Salute, Ricerca Sanitaria Finalizzata, 2010, grant RF-2010-2309849), the European Community’s Health Seventh Framework Programme (FP7/2007-2013 under grant agreement 259867), the Joint Programme – Neurodegenerative Disease Research (Sophia Project, supported by the Italian Ministry of Health, and Strength Project, supported by the Italian Ministry of University and Research), Fondazione Mario e Anna Magnetto, Associazione Piemontese per l’Assistenza alla SLA (APASLA), and Fondazione Vialli e Mauro per la Sclerosi Laterale Amiotrofica onlus.

Declaration of interest

Dr. Moglia reports no disclosures. Dr. Calvo has received research support from the Italian Ministry of Health (Ricerca Finalizzata). Dr. Canosa, Dr. Bertuzzo, Mr. Cugnasco, Dr. Solero, Dr. Grassano, Dr. Bersano, Dr. Cammarosano, Dr. Manera, Dr. Pisano, and Dr. Mazzini report no disclosures. Dr. Dalla Vecchia has received research support from Agenzia Italiana per la Ricerca sulla SLA (ARISLA). Dr. Mora has received research support from the Italian Ministry of Health (Ricerca Finalizzata), and Agenzia Italiana per la Ricerca sulla SLA (ARISLA). Dr. Chiò serves on the editorial advisory board of Amyotrophic Lateral Sclerosis and has received research support from the Italian Ministry of Health (Ricerca Finalizzata), Regione Piemonte (Ricerca Finalizzata), University of Turin, Fondazione Vialli e Mauro onlus, and the European Commission (Health Seventh Framework Programme); he has served on scientific advisory boards for Biogen Idec, Cytokinetics, Neuraltus, Mitsubishi Tanabe, and Italfarmaco.