Link between cardiovascular disease and spinal cord injury: new evidence and update.

According to the most recent report by the National Spinal Cord Injury Statistical Center, hypertensive disorders and the resulting ischemic heart disease constitute the third leading cause of mortality in patients with spinal cord injuries (SCI).1 Increased vascular and inflammatory markers are indicators of increased cardiovascular risk.2 Abnormal cardiovascular control is related to the level and severity of injury to descending autonomic (sympathetic) pathways.3 The results of a systematic review covering studies published in English from 1990 to 2007 indicated that the quality of evidence regarding SCI status as an independent predictor of cardiovascular morbidity and mortality was suboptimal.4 The limited number of studies that investigated a link between CVD and SCI had small sample size, lacked appropriate control groups or adjustment for key confounders, and varied widely in reported outcomes.