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Cited by 15Amyotrophic Lateral Sclerosis ResearchMultiple Sclerosis Research StudiesDementia and Cognitive Impairment Research

Cardiovascular Diseases, Medications, and ALS: A Population-Based Case-Control Study

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Abdel Magid, Hoda S., Topol, Barbara, McGuire, Valerie, Hinman, Jessica A., Kasarskis, Edward J., Nelson, Lorene M.·2022·Neuroepidemiology
DOI 10.1159/000526982PMC PMC9986836
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Abstract

Introduction: We investigated the associations between antecedent all-cause CVD diagnoses, cause-specific CVD diagnosis, and CVD medication prescriptions with the risk of developing amyotrophic lateral sclerosis (ALS). Materials and Methods: We conducted a population-based case-control study of U.S. Medicare enrollees from 2006 to 2013. The final sample included 3,714 incident ALS cases and 18,570 controls (matched on age, sex, enrollment length, and county). Information was collected from Medicare Parts A, B, and D administrative claims data on hypertension, ischemic heart disease, heart failure, acute myocardial infarction, atrial fibrillation, prescriptions of angiotensin-converting enzyme inhibitors, angiotensin II receptors blockers, calcium channel blockers, beta blockers, and antiarrhythmics. Associations were evaluated using conditional logistic regression adjusting for age, sex, race/ethnicity, geographical location, alcohol and tobacco use, and socioeconomic status. Results: The odds ratio (OR) for having one or more ICD-9 codes for any cardiovascular disease diagnosis at least 24 months prior to the date of ALS diagnosis was 0.85 (95% confidence interval [CI]: 0.78–0.92). Cardiovascular conditions that were inversely associated with ALS included heart failure (OR = 0.79; 95% CI 0.70–0.89), atrial fibrillation (OR = 0.81; 95% CI 0.77–0.92), and hypertension (OR = 0.91; 95% CI 0.84–0.98). Exposures to several classes of cardiovascular medications were inversely associated with ALS risk even after adjusting for confounding by indication, including ACE inhibitors (OR = 0.84, 95% CI 0.77–0.91), calcium channel blockers (OR = 0.64, 95% CI 0.59–0.70), and beta blockers (OR = 0.76, 95% CI 0.71–0.83). Discussion/Conclusion: These findings merit additional research, including animal studies and pilot clinical trials, to further evaluate and evidence the effects of ACEIs, CCBs, and BBs on the risk of developing and clinical expression of ALS.

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Cited by

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Authors
Abdel Magid, H. S., Topol, B., McGuire, V., Hinman, J. A., Kasarskis, E. J., & Nelson, L. M.
Affiliations
  • Stanford Medicine (US)
  • University of Kentucky (US)
Corresponding author
Nelson, Lorene M.
ORCID
Venue
Neuroepidemiology
Publisher
S. Karger AG
Published
2022
Volume
56
Issue
6
Pages
423-432
ISSN
  • 0251-5350 (ISSN-L)
  • 1423-0208
DOI
10.1159/000526982
PMC
PMC9986836
OpenAlex
W4310949650
Cited by
15
References
2
Citations by year
2026: 6 · 2025: 5 · 2024: 4
FWCI
1.18
Type
journal article
Language
en
Open access
Licence
Locations
  • Neuroepidemiology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
  • Centers for Disease Control and Prevention (R01TS000249)
  • National Heart, Lung, and Blood Institute (T32HL151323)
Topics
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
amyotrophic lateral sclerosis, cardiovascular disease, cardiovascular drugs, ACE inhibitors, calcium channel blockers, beta-blockers, heart failure, atrial fibrillation, hypertension, ischemic heart disease, antiarrhythmic drugs, disease risk factors
MeSH terms
Adrenergic beta-Antagonists, Aged, Amyotrophic Lateral Sclerosis, Angiotensin-Converting Enzyme Inhibitors, Atrial Fibrillation, Calcium Channel Blockers, Cardiovascular Diseases, Medicare, Heart Failure, Humans, Hypertension, United States, Case-Control Studies

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