Abstract
Over the last decade, there have been marked changes in the trends of morbidity and mortality among individuals with spinal cord injury (SCI). With advances in acute care and in the management of septicemia, renal failure, and pneumonia, cardiovascular complications are now a leading cause of death in those with SCI.1 Moreover, several risk factors for cardiovascular disease (CVD) are amplified in individuals with SCI compared with able-bodied individuals, including physical inactivity, dyslipidemia, blood pressure irregularities, chronic inflammation, and abnormal glycemic control.2â€"22. While most of the literature with respect to CVD and SCI has shown a higher prevalence of risk factors for CVD,2â€"22 relatively few studies have examined the prevalence of CVD itself and corresponding risk estimates.23â€"26 None of these studies has provided direct comparisons of risk estimates for multiple CVD outcomes in the SCI population compared to a non-SCI population, with appropriate adjustment for confounding, in a large representative sample. It thus remains unknown whether there is excess risk of both heart disease and stroke (after adjustment for potential confounders) in individuals with SCI. The current study addresses this knowledge gap by utilizing the national Canadian Community Health Survey (CCHS), which is comprised of comprehensive, up-to-date, cross-sectional data. Our aim was to estimate the prevalence of heart disease and stroke outcomes in the SCI population, to compare their risk with a non-SCI population, and to investigate this relationship after controlling for confounders.,Peer reviewed,Published. Received December 02, 2012 ; Accepted April 22, 2013.