Key result
Complex, disabling conditions are linked to ~83% higher cardiovascular risk versus the general population.
Why the study?
This study aimed to quantify CVD risk and examine the roles of traditional risk factors and condition-specific characteristics among individuals with MS, SCI, TBI, CP, poliomyelitis, or spina bifida.
Meta-Analysis (n=1,600,000)
Individuals with complex and disabling neurological and physical conditions face a significantly elevated risk of cardiovascular disease compared to the general population, influenced by both traditional risk factors and condition-specific characteristics.
May inform disability-adjusted CVD risk models; extends associations across conditions but leaves open effects of targeted prevention.
Aim To quantify cardiovascular disease (CVD) risk among individuals with multiple sclerosis (MS), spinal cord injury (SCI), traumatic brain injury (TBI), cerebral palsy (CP), poliomyelitis, or spina bifida, and examine the roles of traditional risk factors and condition-specific characteristics. Methods We systematically searched Embase, MEDLINE, and Web of Science from inception to March 2025. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects meta-analyses were conducted, and heterogeneity, publication bias, and study quality were evaluated. Sex was considered according to SAGER guidelines. Results Thirty-eight studies involving over 1.6 million individuals were included. Individuals with disabling conditions had higher CVD risk estimates than the general population (IRR = 1.80; HR = 1.83; OR = 2.21). Substantial between-study heterogeneity was observed. MS and SCI were associated with increased risks of stroke, myocardial infarction, and heart failure, while TBI was particularly associated with stroke. Traditional risk factors, including age, sex, diabetes, dyslipidemia, and hypertension, and condition-specific characteristics, including injury severity and recurrence in TBI, injury level in SCI, disease severity in MS, and non-traumatic fractures in CP, were associated with CVD risk or variation in risk estimates. Evidence for some conditions was limited. Conclusions Individuals with disabling conditions had higher CVD risk estimates than the general population, although substantial heterogeneity warrants cautious interpretation. Further research is needed to determine whether tailored cardiovascular risk assessment and preventive strategies improve outcomes.
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Xu et al. (2026) conducted a meta-analysis in Multiple sclerosis, spinal cord injury, traumatic brain injury, cerebral palsy, poliomyelitis, or spina bifida (n=1,600,000). Complex and disabling health conditions (MS, SCI, TBI, CP, poliomyelitis, spina bifida) vs. General population was evaluated on Cardiovascular disease risk (IRR 1.80; HR 1.83; OR 2.21). Complex and disabling health conditions were associated with higher cardiovascular disease risk compared to the general population (IRR 1.80; HR 1.83; OR 2.21).
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