{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:33:25Z","timestamp":1791923605912,"version":"4.3.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T00:00:00Z","timestamp":1680825600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Vascular management in People with Multiple Sclerosis (PwMS) is important given the higher vascular burden than the general population, associated with increased disability and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We assessed differences in the prevalence of type 2 diabetes and hypertension; and the use of antidiabetic, antihypertensive and lipid-lowering medications at the time of the MS diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This is a population-based study including PwMS and matched controls between 1987 and 2018 in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 12,251 PwMS and 72,572 matched controls. PwMS had a 30% increased prevalence of type 2 diabetes (95% confidence interval (CI)\u2009=\u20091.19, 1.42). Among those with type 2 diabetes, PwMS had a 56% lower prevalence of antidiabetic usage (95% CI\u2009=\u20090.33, 0.58). Prevalence of hypertension was 6% greater in PwMS (95% CI\u2009=\u20091.05, 1.06), but in those with hypertension, usage of antihypertensive was 66% lower in PwMS (95% CI\u2009=\u20090.28, 0.42) than controls. Treatment with lipid-lowering medications was 63% lower in PwMS (95% CI\u2009=\u20090.54, 0.74). PwMS had a 0.4-mm\u2009Hg lower systolic blood pressure (95% CI\u2009=\u2009\u22120.60, \u22120.13). 3.8% of PwMS were frail.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>At the time of diagnosis, PwMS have an increased prevalence of vascular risk factors, including hypertension and diabetes though paradoxically, there is poorer treatment. Clinical guidelines supporting appropriate vascular assessment and management in PwMS should be developed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585231164296","type":"journal-article","created":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T01:49:22Z","timestamp":1680918562000},"page":"671-679","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Management of vascular risk in people with multiple sclerosis at the time of diagnosis in England: A population-based study"],"prefix":"10.1177","volume":"29","author":[{"given":"Raffaele","family":"Palladino","sequence":"first","affiliation":[{"name":"Department of Primary Care and Public Health, School of Public Health, Imperial College of London, London, UK\/Department of Public Health, Federico II University, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1855-5595","authenticated-orcid":false,"given":"Ruth Ann","family":"Marrie","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azeem","family":"Majeed","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, School of Public Health, Imperial College of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Chataway","sequence":"additional","affiliation":[{"name":"Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK\/National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,4,7]]},"reference":[{"key":"bibr1-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.0664"},{"key":"bibr2-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000230"},{"key":"bibr3-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001718"},{"key":"bibr4-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.101987"},{"key":"bibr5-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002474"},{"key":"bibr6-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002481"},{"key":"bibr7-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514564491"},{"key":"bibr8-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181d6b125"},{"key":"bibr9-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001187"},{"key":"bibr10-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12720"},{"key":"bibr11-13524585231164296","volume-title":"Cardiovascular disease: Risk assessment and reduction, including lipid modification","author":"National Institute for Health and Care Excellence","year":"2014"},{"key":"bibr12-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520987541"},{"key":"bibr13-13524585231164296","unstructured":"Clinical practice research datalink (CPRD), https:\/\/cprd.com\/"},{"key":"bibr14-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdt116"},{"key":"bibr15-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012610"},{"key":"bibr16-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007043"},{"key":"bibr17-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1214\/09-STS313"},{"key":"bibr18-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-58033-3"},{"key":"bibr19-13524585231164296","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7399.1130"},{"key":"bibr20-13524585231164296","unstructured":"GOV.UK. 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