Cardiovascular Health after Spinal Cord Injury: A Comprehensive Examination of Traditional and Emerging Risk Factors

The objectives of this study were to assess traditional and emerging cardiovascular disease (CVD) risk factors among individuals with chronic spinal cord injury (SCI). A small comparison group of able-bodied (AB) men matched for age and sex to individuals with paraplegia was included. Thirty-four individuals with chronic SCI and eight able-bodied individuals participated. No group differences were found regarding prevalence of metabolic disease. Moreover, no group differences were found for indices of local (carotid distensibility) or regional artery stiffness or local (brachial, superficial femoral) artery function (flow-mediated dilation, nitroglycerin). When comparing the matched paraplegia and AB groups, the participants with paraplegia had significantly less leg lean mass and lower peak aerobic capacity, power output, and ventilation when compared to the AB group. The paraplegia group also had lower carotid artery distensibility and superficial-femoral-artery flow-mediated dilation after adjusting for baseline diameter when compared to the matched AB group. It was concluded that emerging risk factors of body composition, aerobic fitness, and peripheral vascular measures may better describe CVD risk in the SCI population that traditional risk factors. Reduced carotid artery distensibility and percentage of SFA FMD in paraplegia versus matched AB suggests that decreased physical activity and paralysis affect vascular structure and function. Mechanisms underlying vascular dysfunction after SCI have not been adequately investigated; future studies with larger representative groups are necessary to characterize relationships between emerging risk factors and CVD outcomes in individuals with SCI.