SCI: Lifelong Cardiovascular Risk Must Be Mitigated

2016-05-22 18:15:00 (GMT) (Caymanmama.com - News Providers Press Release News)

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SCI: Lifelong Cardiovascular Risk Must Be Mitigated

Sacramento, CA, 05/20/2016 /SubmitPressRelease123/

Cardiovascular disease (CVD) is the leading cause of mortality in the United States, half of which is directly related to coronary heart disease (CHD).  Studies indicate that CVD, CHD, and irregular heart rhythms are more common in persons with spinal cord injury (SCI).   Physicians must understand this and advocate for life style changes, aggressive medication management, necessary follow up care, and diagnostic testing to prevent and treat latent disease.

 

SCI patients more frequently have impaired glucose tolerance and diabetes mellitus than the age matched population.  Insulin resistance develops along with increased fat mass that is associated with the development of plaques in the medium and small arteries that are responsible for CVD and CHD.

 

Lipid metabolism is impaired in SCI that contributes to CVD and CHD. SCI leads to an elevation of LDL cholesterol, known as ‘bad cholesterol and there is a decrease in HDL cholesterol, known as ‘good cholesterol’.  Approximately 10% of the United States population has decrease HDL cholesterol levels while up to 40% of persons chronically injured by SCI have decreased HDL cholesterol levels supporting the assertion that lipid metabolism is impaired by SCI.  Further support is that studies indicate that quadriplegics have more significant abnormalities in their cholesterol profiles than paraplegics.

 

CHD in SCI accounts for nearly 50% of the deaths in persons over thirty years of age.  Unfortunately most primary care physicians are not aware of the increased risks of CHD in SCI.  Studies indicate that half of young asymptomatic quadriplegics with normal EKGs with risk factors for CHD have evidence of reversible myocardial ischemia on non-invasive cardiac stress testing.  This means that they are a heart attack waiting to happen.  This emphasizes the fact that asymptomatic SCI patients must be sent for stress testing if there are risk factors such as smoking, diabetes, obesity, elevated cholesterol, or a family.

 

An active life-style is necessary in all patients with SCI with recreational pursuits that support vigorous exercise.  HDL cholesterol or ‘good cholesterol’ has been shown to increase with vigorous exercise.  This promotes weight loss, healthy diet, and smoking cessation.  Recreational therapy must be involved early in Acute Rehabilitation to emphasize avocational activities to promote health.

 

Academic Physician Life Care Planners understand that the higher and more complete the SCI in a catastrophic person exacerbates the metabolic changes that contribute to CVD and CHD.  The life care plan must include screening, recognition, and treatment for those at risk for early CVD.   Fellowship trained physicians in SCI must be involved in the primary care of this patient since they understand the need to have a aggressive treatment plan to mitigate CVD and CHD risk factors.

 

Life Care Plans must include interventions that include life-style changes, recreational therapy that supports an active life-style, aggressive dietary management, cholesterol management, and non-invasive cardiac testing to the patient’s life expectancy.

 

http://www.nature.com/sc/journal/v46/n7/abs/3102161a.html

 

http://cardiology.org/recentpapers/PDF307/SCI%20CV%20Health%20Review.pdf

 

http://www.archives-pmr.org/article/S0003-9993(97)90076-9/abstract

 

http://europepmc.org/abstract/med/11438852

 

Press Contact

Dr. Greg Vigna, MD, JD Academic Physician Life Care Planner

T: 800-761-9206

https://www.lifecare123.com

Connect with Dr. Greg Vigna, MD, JD

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#DrGregVigna

 

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