Interesting study authored by neurologists published in 2010 - Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis.

"Using a large patient population where race and socioeconomic status are known, we examined the influence of vascular comorbidity on disability progression in MS. Vascular comorbidities were frequent but generally occurred at the rates expected for the general population.18 The risk associated with vascular comorbidities translated into a substantial difference of 6 years in the time from diagnosis to needing a unilateral assistive device for ambulation. Vascular comorbidity occurring at any time in the disease course was also associated with an increased risk of disability progression; the risk increased by more than 200% in participants with 2 comorbidities. By comparison, pivotal trials of disease-modifying therapies in MS showed effects ranging from none to 42% reduction in the probability of disability progression.19,20 Depending on the agent and study population, the effects of disease-modifying drugs translate into average delays in disability progression of less than 12 months over the course of a 2- to 3-year study, and the benefits on disability progression are less pronounced later in disease.21,22 This suggests that comorbidity has a substantial, important effect on outcome, possibly greater than the effect (in the opposite direction) of disease-modifying drugs used for MS. Furthermore, some vascular conditions are modifiable, raising the possibility that more aggressive treatment of comorbidities could improve outcomes in MS. This is a completely unexplored question, but results here suggest a rationale for aggressive management of vascular risk factors in patients with MS, and for studies to determine its effect on MS severity.
"Using a large patient population where race and socioeconomic status are known, we examined the influence of vascular comorbidity on disability progression in MS. Vascular comorbidities were frequent but generally occurred at the rates expected for the general population.18 The risk associated with vascular comorbidities translated into a substantial difference of 6 years in the time from diagnosis to needing a unilateral assistive device for ambulation. Vascular comorbidity occurring at any time in the disease course was also associated with an increased risk of disability progression; the risk increased by more than 200% in participants with 2 comorbidities. By comparison, pivotal trials of disease-modifying therapies in MS showed effects ranging from none to 42% reduction in the probability of disability progression.19,20 Depending on the agent and study population, the effects of disease-modifying drugs translate into average delays in disability progression of less than 12 months over the course of a 2- to 3-year study, and the benefits on disability progression are less pronounced later in disease.21,22 This suggests that comorbidity has a substantial, important effect on outcome, possibly greater than the effect (in the opposite direction) of disease-modifying drugs used for MS. Furthermore, some vascular conditions are modifiable, raising the possibility that more aggressive treatment of comorbidities could improve outcomes in MS. This is a completely unexplored question, but results here suggest a rationale for aggressive management of vascular risk factors in patients with MS, and for studies to determine its effect on MS severity."


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848107/


Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis
www.ncbi.nlm.nih.gov
Vascular comorbidity adversely influences health outcomes in several chronic conditions. Vascular comorbidities are common in multiple sclerosis (MS), but their impact on disease severity is unknown. Vascular comorbidities may contribute to the poorly understood heterogeneity in MS disease severity.…