CARDIOVASCULAR DISEASE RISK AND THE NEED FOR PREVENTION AFTER PARAPLEGIA DETERMINED BY CONVENTIONAL MULTIFACTORIAL RISK MODELS: THE STOCKHOLM SPINAL CORD INJURY STUDY

Objective: To assess the need for intervention on cardiovascular disease risks in persons with paraplegia according to: (i) two multifactorial risk models; and (ii) these models in combination with the additional risk of overweight/obesity. Design: Cross-sectional. Subjects: A total of 134 out of 153 persons, comprising more than 80% of a regional prevalence population with traumatic paraplegia (American Spinal Injury Association Impairment Scale A C) of minimum one year duration. Methods: Participants were screened for cardiovascular disease risk using two multifactorial risk models: the Systematic Coronary Risk Evaluation and the Framingham Risk Equation. Risk factors included were: age, gender, systolic blood pressure, antihypertensive medication, smoking, total cholesterol, high-density lipoprotein cholesterol, and total cholesterol/total cholesterol ratio. In addition, overweight/obesity was assessed by body mass index. Results: Twenty-seven percent to 36% of the cohort was eligible for cardiovascular disease risk intervention, depending on the risk model used. When overweight/obesity (spinal cord injury adjusted cut-score body mass index. >= 22) was also considered, over 80% of the participants qualified for intervention. Conclusion: Almost one-third of persons with paraplegia were eligible for cardiovascular disease risk intervention according to authoritative assessment tools. The number in need of intervention was dramatically increased when overweight/obesity as a cardiovascular disease risk was considered.