Background:Vascular management in People with Multiple Sclerosis (PwMS) is important
given the higher vascular burden than the general population, associated
with increased disability and mortality.Objectives:We assessed differences in the prevalence of type 2 diabetes and
hypertension; and the use of antidiabetic, antihypertensive and
lipid-lowering medications at the time of the MS diagnosis.Methods:This is a population-based study including PwMS and matched controls between
1987 and 2018 in England.Results:We identified 12,251 PwMS and 72,572 matched controls. PwMS had a 30%
increased prevalence of type 2 diabetes (95% confidence interval
(CI) = 1.19, 1.42). Among those with type 2 diabetes, PwMS had a 56% lower
prevalence of antidiabetic usage (95% CI = 0.33, 0.58). Prevalence of
hypertension was 6% greater in PwMS (95% CI = 1.05, 1.06), but in those with
hypertension, usage of antihypertensive was 66% lower in PwMS (95%
CI = 0.28, 0.42) than controls. Treatment with lipid-lowering medications
was 63% lower in PwMS (95% CI = 0.54, 0.74). PwMS had a 0.4-mm Hg lower
systolic blood pressure (95% CI = −0.60, −0.13). 3.8% of PwMS were
frail.Conclusion:At the time of diagnosis, PwMS have an increased prevalence of vascular risk
factors, including hypertension and diabetes though paradoxically, there is
poorer treatment. Clinical guidelines supporting appropriate vascular
assessment and management in PwMS should be developed.