Multiple Sclerosis and Atherosclerosis: What’s the Connection?

Despite their similar names, atherosclerosis and multiple sclerosis (MS) are very different diseases. But due to certain factors, people with MS may be more likely to have atherosclerosis than the general population.

Multiple sclerosis is an autoimmune disease and neurological disorder, and atherosclerosis (plaque buildup in the arteries) is a heart-related condition. They may be associated in two main ways.

MS may lead to poorer heart health due to some medication side effects, research suggests. MS and atherosclerosis also have several risk factors in common. People with MS may have a higher risk of heart disease due to some of these shared risk factors, which include:

• High blood pressure: People with MS have higher rates of high blood pressure, which is also a risk factor for atherosclerosis.
• High cholesterol: High cholesterol levels have been linked to problems with memory and thinking (brain fog) in people with MS. High cholesterol can lead to plaque buildup in the arteries.
• Smoking: Smoking is a risk factor for both MS and atherosclerosis. It can worsen inflammation and damage your blood vessels and nerves.
• Lack of physical activity: MS symptoms like fatigue or muscle stiffness may make it hard to stay active, and being inactive can increase your risk of atherosclerosis.
• Obesity and overweight: Carrying extra weight puts more stress on your body, which can make MS symptoms worse. It can also increase your risk of high blood pressure and high cholesterol.

Multiple sclerosis and atherosclerosis have similarities:

• Both involve the immune system: In atherosclerosis, your immune system reacts to damaged blood vessels. The resulting inflammation can cause plaque to form and build up in your arteries. In MS, your immune system attacks the protective coating of the nerves in your brain and spinal cord, making it more challenging for your brain to send signals to your body. 
• Both are chronic (long-term) conditions: Atherosclerosis is a slow-to-progress, long-term disease caused by the buildup of fat and cholesterol in the arteries. MS is also a lifelong condition that can lead to ongoing symptoms.
• Both can affect your quality of life: Atherosclerosis can cause heart attacks, strokes, poor blood flow to the legs, or bulging arteries. MS can affect daily life through long-term symptoms that may get worse over time and often require care from different medical specialists. 

MS and atherosclerosis affect the body in very different ways, including:

• Symptoms: Atherosclerosis can cause chest pain, leg cramps while walking, or symptoms of stroke like trouble speaking. MS symptoms vary widely and may include vision problems, numbness, muscle weakness, fatigue, and trouble with balance or walking.
• Age of onset: MS usually begins between the ages of 20 and 40. Atherosclerosis can start early in life, but it usually doesn’t cause symptoms until people are older—the risk increases after age 45 for men and age 55 for women.
• Treatment: You may be able to manage atherosclerosis with lifestyle changes and medications to help lower blood pressure, cholesterol, and other risk factors. MS requires treatment with therapies to slow nerve damage, prevent or respond to flare-ups, and manage symptoms.

There are several ways to stay on top of your health if you have multiple sclerosis and are at risk for or already have atherosclerosis.

• Make lifestyle changes that help both conditions: Eat heart-healthy foods, avoid smoking and secondhand smoke, manage stress, and exercise regularly at your own pace. Gentle movement like walking, yoga, or swimming can improve blood flow and may ease MS symptoms and reduce your risk of atherosclerosis.
• Get regular check-ups: Check your blood pressure, cholesterol, and blood sugar levels regularly. Ask a healthcare provider to monitor your heart health even if you don’t have symptoms, and let them know if you have chest pain, shortness of breath, or leg swelling.
• Use a coordinated care approach: Work with a team. It may help to have a primary care provider, a neurologist (specialist in nerve-related conditions like MS), and a cardiologist (heart specialist) who communicate with each other. You can also ask about physical therapy or rehab programs that can improve your mobility, strength, and heart health.

It’s important to stay in touch with a healthcare provider to help manage atherosclerosis and MS. Delayed treatment for either condition can lead to serious complications, such as heart attack, stroke, or long-term disability.

Contact your healthcare provider right away if you notice any of the following:

• Uncontrolled blood pressure or blood sugar levels
• Unusual bruising or bleeding while taking aspirin or blood thinners
• Difficulty taking medications
• Difficulty moving your joints, moving around, or getting out of your bed or chair
• Skin sores or redness
• Pain that is becoming worse
• Recent falls
• Choking or coughing when eating
• Signs of a bladder infection

Atherosclerosis and multiple sclerosis are both long-term conditions that involve the immune system and can lead to serious health complications. While they share some risk factors like inflammation, high cholesterol, and lack of physical activity, they are distinct conditions. MS affects your brain and nerves, while atherosclerosis affects the cardiovascular system.

If you have MS, you may be more likely to have atherosclerosis. Early detection, healthy lifestyle choices, and regular checkups can help manage both conditions and improve quality of life.