BACKGROUND The role of cardiovascular risk factors in amyotrophic lateral sclerosis (ALS) is controversial. A favourable profile has been found in ALS patients, but previous studies have not specifically considered the profile in different disease phenotypes. METHODS Demographic data, smoking habits, lifetime exercise, and medical history including diabetes mellitus, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, stroke, and cardiac events, were analysed in ALS patients and in controls with other neurological disorders, utilising a standardized questionnaire applied by the same neurologist. In ALS patients the results were analysed according to their different phenotypes. Univariate analyses and multinomial logistic models were applied to estimate the odds ratios (ORs) and confidence intervals (CIs) for covariates, to test potential modifiers and their effects. RESULTS 500 consecutively assessed adult ALS patients (mean age 65.6, 47% women, and 136 bulbar-onset) and 327 age and gender-matched controls were studied. Patients with spinal-onset ALS took more exercise (p = 0.012), reported less hypertension (p = 0.002) and had fewer cardiac events (p = 0.012). Multinomial regression analysis showed that men without hypertension have a higher risk of having spinal-onset ALS (p < 0.001) while female with hypertension have a higher risk of having bulbar-onset ALS (p = 0.033). CONCLUSIONS Risk-factors in ALS can be influenced by gender and phenotype. This study suggests that men with spinal ALS are healthier, exercise more and have lower rate of hypertension, but females with bulbar-onset ALS are more prone to hypertension. The complex interplay between exercise, diet and comorbidities with ALS phenotype requires further investigation.

中文翻译：

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肌萎缩侧索硬化的心血管并发症

背景 心血管危险因素在肌萎缩侧索硬化 (ALS) 中的作用是有争议的。在 ALS 患者中发现了一个有利的特征，但以前的研究没有专门考虑不同疾病表型的特征。方法 对 ALS 患者和患有其他神经系统疾病的对照组的人口统计学数据、吸烟习惯、终生锻炼和病史（包括糖尿病、动脉高血压、高胆固醇血症、高甘油三酯血症、中风和心脏事件）进行分析。同一个神经科医生。在 ALS 患者中，根据他们不同的表型分析结果。应用单变量分析和多项逻辑模型来估计协变量的优势比 (OR) 和置信区间 (CI)，测试潜在的修饰符及其效果。结果 对 500 名连续评估的成年 ALS 患者（平均年龄 65.6 岁，47% 女性，136 名延髓发病）和 327 名年龄和性别匹配的对照进行了研究。脊髓型 ALS 患者进行更多运动 (p = 0.012)，报告的高血压较少 (p = 0.002) 和心脏事件较少 (p = 0.012)。多项回归分析显示，没有高血压的男性患脊髓型 ALS 的风险较高（p <0.001），而患有高血压的女性患延髓型 ALS 的风险较高（p = 0.033）。结论 ALS 的危险因素可能受性别和表型的影响。这项研究表明，患有脊柱 ALS 的男性更健康，运动更多，高血压发病率更低，但患有延髓 ALS 的女性更容易患高血压。运动之间复杂的相互作用，