Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 6 , Pages 751-757 , June 2007

A Guideline-Driven Assessment of Need for Cardiovascular Disease Risk Intervention in Persons With Chronic Paraplegia

  • Mark S. Nash, PhD

      Affiliations

    • Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL
    • Department of Rehabilitation Medicine, Miller School of Medicine, University of Miami, Miami, FL
    • Department of Physical Therapy, Miller School of Medicine, University of Miami, Miami, FL
    • Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL
    • Corresponding Author InformationReprint requests to Mark S. Nash, PhD, The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Lois Pope Life Center, R-48, 1095 NW 14th Ter, Miami, FL 33136
  • ,
  • Armando J. Mendez, PhD

      Affiliations

    • Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL
    • Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL.

References 

  1. Gerhart KA, Bergstrom E, Charlifue SW, Menter RR, Whiteneck GG. Long-term spinal cord injury: functional changes over time. Arch Phys Med Rehabil. 1993;74:1030–1034
  2. Bauman WA. The endocrine system. In:  Whiteneck GG,  Charlifue SW,  Gerhart KA editor. Aging with spinal cord injury. New York: Demos; 1993;p. 139–158
  3. Samsa GP, Patrick CH, Feussner JR. Long-term survival of veterans with traumatic spinal cord injury. Arch Neurol. 1993;50:909–914
  4. Bauman WA, Spungen AM, Adkins RH, Kemp BJ. Metabolic and endocrine changes in persons aging with spinal cord injury. Assist Technol. 1999;11:88–96
  5. Bauman WA, Raza M, Chayes Z, Machac J. Tomographic thallium-201 myocardial perfusion imaging after intravenous dipyridamole in asymptomatic subjects with quadriplegia. Arch Phys Med Rehabil. 1993;74:740–744
  6. Groah SL, Menter RR. Long-term cardiac ischemia leading to coronary artery bypass grafting in a tetraplegic patient. Arch Phys Med Rehabil. 1998;79:1129–1132
  7. Bauman WA, Spungen AM, Raza M, et al. Coronary artery disease: metabolic risk factors and latent disease in individuals with paraplegia. Mt Sinai J Med. 1992;59:163–168
  8. Groah SL, Stiens SA, Gittler MS, Kirshblum SC, McKinley WO. Spinal cord injury medicine (5. Preserving wellness and independence of the aging patient with spinal cord injury: a primary care approach for the rehabilitation medicine specialist). Arch Phys Med Rehabil. 2002;83(3 Suppl 1):S82–S89S90-8
  9. Bauman WA, Spungen AM, Zhong YG, Rothstein JL, Petry C, Gordon SK. Depressed serum high density lipoprotein cholesterol levels in veterans with spinal cord injury. Paraplegia. 1992;30:697–703
  10. Brenes G, Dearwater S, Shapera R, LaPorte RE, Collins E. High density lipoprotein cholesterol concentrations in physically active and sedentary spinal cord injured patients. Arch Phys Med Rehabil. 1986;67:445–450
  11. Karlsson AK, Attvall S, Jansson PA, Sullivan L, Lonnroth P. Influence of the sympathetic nervous system on insulin sensitivity and adipose tissue metabolism: a study in spinal cord-injured subjects. Metabolism. 1995;44:52–58
  12. Zlotolow SP, Levy E, Bauman WA. The serum lipoprotein profile in veterans with paraplegia: the relationship to nutritional factors and body mass index. J Am Paraplegia Soc. 1992;15:158–162
  13. Maki KC, Briones ER, Langbein WE, et al. Associations between serum lipids and indicators of adiposity in men with spinal cord injury. Paraplegia. 1995;33:102–109
  14. McGlinchey-Berroth R, Morrow L, Ahlquist M, Sarkarati M, Minaker KL. Late-life spinal cord injury and aging with a long term injury: characteristics of two emerging populations. J Spinal Cord Med. 1995;18:183–193
  15. Bauman WA, Adkins RH, Spungen AM, et al. Is immobilization associated with an abnormal lipoprotein profile? (Observations from a diverse cohort). Spinal Cord. 1999;37:485–493
  16. Washburn RA, Figoni SF. High density lipoprotein cholesterol in individuals with spinal cord injury: the potential role of physical activity. Spinal Cord. 1999;37:685–695
  17. Berg A, Halle M, Franz I, Keul J. Physical activity and lipoprotein metabolism: epidemiological evidence and clinical trials. Eur J Med Res. 1997;2:259–264
  18. Schaefer EJ, Lamon-Fava S, Ordovas JM, et al. Factors associated with low and elevated plasma high density lipoprotein cholesterol and apolipoprotein A-I levels in the Framingham Offspring Study. J Lipid Res. 1994;35:871–882
  19. Castelli WP. Epidemiology of coronary heart disease: the Framingham study. Am J Med. 1984;76:4–12
  20. Castelli WP, Anderson K, Wilson PW, Levy D. Lipids and risk of coronary heart disease (The Framingham Study). Ann Epidemiol. 1992;2:23–28
  21. Smith SC. Multiple risk factors for cardiovascular disease and diabetes mellitus. Am J Med. 2007;120(3 Suppl 1):S3–S11
  22. Nam BH, Kannel WB, D’Agostino RB. Search for an optimal atherogenic lipid risk profile: from the Framingham Study. Am J Cardiol. 2006;97:372–375
  23. Chapman MJ. Therapeutic elevation of HDL-cholesterol to prevent atherosclerosis and coronary heart disease. Pharmacol Ther. 2006;111:893–908
  24. Bowen PH, Guyton JR. Nonpharmacologic and pharmacologic treatment of patients with low levels of high-density lipoprotein cholesterol. Curr Atheroscler Rep. 2000;2:58–63
  25. Kwiterovich PO. State-of-the-art update and review: clinical trials of lipid-lowering agents. Am J Cardiol. 1998;82:3U–17Udiscussion 39U-41U
  26. Guinchard-Foulon E, Rodriguez-Lafrasse C, Rousson R. HDL-cholesterol: role of its dosage in the assessment of cardiovascular risk. Ann Biol Clin (Paris). 2003;61:549–556
  27. Gordon DJ, Rifkind BM. High-density lipoprotein—the clinical implications of recent studies. N Engl J Med. 1989;321:1311–1316
  28. Nesto RW. Beyond low-density lipoprotein: addressing the atherogenic lipid triad in type 2 diabetes mellitus and the metabolic syndrome. Am J Cardiovasc Drugs. 2005;5:379–387
  29. McKenney JM. Update on the National Cholesterol Education Program Adult Treatment Panel III guidelines: getting to goal. Pharmacotherapy. 2003;23(9 Pt 2):26S–33S
  30. National Cholesterol Education Program. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). Circulation. 1994;89:1333–1445
  31. Knopp RH, Mishell DR. Cholesterol treatment recommendations for adults: highlights of the 1987 report from the National Cholesterol Education Program Adult Treatment Panel. Am J Obstet Gynecol. 1988;158:1670–1674
  32. Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (The Expert Panel). Arch Intern Med. 1988;48:36–69
  33. Rubinstein A. National Cholesterol Education Program (Second report of the Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults). Circulation. 1995;91:908–909
  34. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report). Circulation. 2002;106:3143–3421
  35. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)). JAMA. 2001;285:2486–2497
  36. Bauman WA, Spungen AM. Metabolic changes in persons after spinal cord injury. Phys Med Rehabil Clin N Am. 2000;11:109–140
  37. Duckworth WC, Solomon SS, et al. Glucose intolerance due to insulin resistance in patients with spinal cord injuries. Diabetes. 1980;29:906–910
  38. Myers J, Lee M, Kiratli J. Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management. Am J Phys Med Rehabil. 2007;86:142–152
  39. Kocina P. Body composition of spinal cord injured adults. Sports Med. 1997;23:48–60
  40. Nash MS, Jacobs PL, Mendez AJ, Goldberg RB. Circuit resistance training improves the atherogenic lipid profiles of persons with chronic paraplegia. J Spinal Cord Med. 2001;24:2–9
  41. Bachorik PS, Albers JJ. Precipitation methods for quantification of lipoproteins. Methods Enzymol. 1986;129:78–100
  42. Friedewald W, Levy R, Fredrickson D. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of preparative ultracentrifugation. Clin Chem. 1972;18:499
  43. Dearwater SR, LaPorte RE, Robertson RJ, Brenes G, Adams LL, Becker D. Activity in the spinal cord-injured patient: an epidemiologic analysis of metabolic parameters. Med Sci Sports Exerc. 1986;18:541–544
  44. LaPorte RE, Adams LL, Savage DD, Brenes G, Dearwater S, Cook T. The spectrum of physical activity, cardiovascular disease and health: an epidemiologic perspective. Am J Epidemiol. 1984;120:507–517
  45. Bauman WA, Spungen AM. Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging. Metabolism. 1994;43:749–756
  46. Linn S, Fulwood R, Carroll M, et al. Serum total cholesterol: HDL cholesterol ratios in US white and black adults by selected demographic and socioeconomic variables (HANES II). Am J Public Health. 1991;81:1038–1043
  47. Demirel S, Demirel G, Tukek T, Erk O, Yilmaz H. Risk factors for coronary heart disease in patients with spinal cord injury in Turkey. Spinal Cord. 2001;39:134–138
  48. Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. J Am Coll Cardiol. 2004;44:720–732
  49. Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lefant C. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109:433–438
  50. Spungen AM, Adkins RH, Stewart CA, et al. Factors influencing body composition in persons with spinal cord injury: a cross-sectional study. J Appl Physiol. 2003;95:2398–2407
  51. Bostom AG, Toner MM, McArdle WD, Montelione T, Brown CD, Stein RA. Lipid and lipoprotein profiles relate to peak aerobic power in spinal cord injured men. Med Sci Sports Exerc. 1991;23:409–414
  52. Washburn RA, Figoni SF. Physical activity and chronic cardiovascular disease prevention in spinal cord injury: a comprehensive literature review. Top Spinal Cord Inj Rehabil. 1998;3:16–32
  53. Bauman WA, Kahn NN, Grimm DR, Spungen AM. Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury. Spinal Cord. 1999;37:601–616
  54. Pietrobelli A, Lee RC, Capristo E, Deckelbaum RJ, Heymsfield SB. An independent, inverse association of high-density-lipoprotein-cholesterol concentration with nonadipose body mass. Am J Clin Nutr. 1999;69:614–620
  55. Kwiterovich PO. The antiatherogenic role of high-density lipoprotein cholesterol. Am J Cardiol. 1998;82:13Q–21Q
  56. Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against coronary heart disease (The Framingham Study). Am J Med. 1977;62:707–714
  57. Assmann G, Schulte H, von Eckardstein A, Huang Y. High-density lipoprotein cholesterol as a predictor of coronary heart disease risk (The PROCAM experience and pathophysiological implications for reverse cholesterol transport). Atherosclerosis. 1996;124(Suppl):S11–S20
  58. Lipid Research Clinics Coronary Primary Prevention Trial Results (II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering). JAMA. 1984;251:365–374
  59. Frick MH, Elo O, Haapa K, et al. Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia (Safety of treatment, changes in risk factors, and incidence of coronary heart disease). N Engl J Med. 1987;317:1237–1245
  60. Sirtori CR, Calabresi L, Marchioli R, Rubins HB. Cardiovascular risk changes after lipid lowering medications: are they predictable?. Atherosclerosis. 2000;152:1–8
  61. Bloomfield Rubins H, Davenport J, et al. Reduction in stroke with gemfibrozil in men with coronary heart disease and low HDL cholesterol: The Veterans Affairs HDL Intervention Trial (VA-HIT). Circulation. 2001;103:2828–2833
  62. Downs JR, Clearfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS (Air Force/Texas Coronary Atherosclerosis Prevention Study). JAMA. 1998;279:1615–1622
  63. Pearson TA, Laurora I, Chu H, Kafonek S. The Lipid Treatment Assessment Project (L-TAP): a multicenter survey to evaluate the percentages of dyslipidemic patients receiving lipid-lowering therapy and achieving low-density lipoprotein cholesterol goals. Arch Intern Med. 2000;160:459–467
  64. EUROASPIRE. A European Society of Cardiology survey of secondary prevention of coronary heart disease: principal results. EUROASPIRE Study Group. European Action on Secondary Prevention through Intervention to Reduce Events. Eur Heart J. 1997;18:1569–1582
  65. EUROASPIRE II Study Group. Lifestyle and risk factor management and use of drug therapies in coronary patients from 15 countries; principal results from EUROASPIRE II Euro Heart Survey Programme. Eur Heart J. 2001;22:554–572
  66. Pyorala K, Lehto S, De Bacquer D, et al. Risk factor management in diabetic and non-diabetic patients with coronary heart disease (Findings from the EUROASPIRE I AND II surveys). Diabetologia. 2004;47:1257–1265
  67. Bauman WA, Raza M, Spungen AM, Machac J. Cardiac stress testing with thallium-201 imaging reveals silent ischemia in individuals with paraplegia. Arch Phys Med Rehabil. 1994;75:946–950
  68. Tousoulis D, Davies G, Ambrose J, Tentolouris C, Stefanadis C, Toutouzas P. Effects of lipids on thrombotic mechanisms in atherosclerosis. Int J Cardiol. 2002;86:239–247
  69. Krum H, Howes LG, Brown DJ, et al. Risk factors for cardiovascular disease in chronic spinal cord injury patients. Paraplegia. 1992;30:381–388
  70. Spungen AM, Lesser M, Almenoff PL, Bauman WA. Prevalence of cigarette smoking in a group of male veterans with chronic spinal cord injury. Mil Med. 1995;160:308–311
  71. Davies DS, McColl MA. Lifestyle risks for three disease outcomes in spinal cord injury. Clin Rehabil. 2002;16:96–108
  72. Spungen AM, Grimm DR, Schilero G, et al. Relationship of respiratory symptoms with smoking status and pulmonary function in chronic spinal cord injury. J Spinal Cord Med. 2002;25:23–27
  73. Karlsson AK. Insulin resistance and sympathetic function in high spinal cord injury. Spinal Cord. 1999;37:494–500
  74. Jones LM, Goulding A, Gerrard DF. DEXA: a practical and accurate tool to demonstrate total and regional bone loss, lean tissue loss and fat mass gain in paraplegia. Spinal Cord. 1998;36:637–640
  75. Spungen AM, Bauman WA, Wang J, Pierson RN. Measurement of body fat in individuals with tetraplegia: a comparison of eight clinical methods. Paraplegia. 1995;33:402–408
  76. Weitzenkamp DA, Jones RH, Whiteneck GG, Young DA. Ageing with spinal cord injury: cross-sectional and longitudinal effects. Spinal Cord. 2001;39:301–309
  77. Thomason SS. Aging: a common denominator of disability. SCI Nurs. 2001;18:3
  78. Capoor J, Stein AB. Aging with spinal cord injury. Phys Med Rehabil Clin N Am. 2005;16:129–161
  79. Karlsson AK, Elam M, Friberg P, Biering-Sorensen F, Sullivan L, Lonnroth P. Regulation of lipolysis by the sympathetic nervous system: a microdialysis study in normal and spinal cord-injured subjects. Metabolism. 1997;46:388–394
  80. Levine AM, Nash MS, Green BA, Shea JD, Aronica MJ. An examination of dietary intakes and nutritional status of chronic healthy spinal cord injured individuals. Paraplegia. 1992;30:880–889

 Supported by the Miami Project to Cure Paralysis and the State of Florida (allocation grant).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)00167-0

doi: 10.1016/j.apmr.2007.02.031

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 6 , Pages 751-757 , June 2007