Mark S Nash1, Armando J Mendez. 1. Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. mnash@med.miami.edu
Abstract
OBJECTIVE: To examine percentages of persons with chronic paraplegia who qualify for lipid-lowering therapeutic lifestyle intervention (TLI) as assessed by authoritative guidelines. DESIGN: Cross-sectional. SETTING: Academic medical center. PARTICIPANTS: Forty-one subjects (mean age +/- standard deviation, 34+/-11 y) with motor-complete paraplegia (American Spinal Injury Association grade A or B) at T6-L1 levels for greater than 2 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Percentages of subjects qualifying for TLI were independently assessed and then compared using National Cholesterol Education Project Adult Treatment Panel (ATP) II (1994) and ATP III (2002) Guidelines. RESULTS: A total of 34.1% of subjects qualified for intervention based on the ATP II Guidelines and 63.4% based on ATP III (chi1(2) test=4.53; 2-tailed, P=.003). Seventy-six percent (31/41) of study participants had high-density lipoprotein cholesterol levels below the high-risk criterion of 40 mg/dL established by ATP III. Almost one third of subjects had hypertension, and 34.1% satisfied criteria for diagnosis of the metabolic syndrome. CONCLUSIONS: A high percentage of young, apparently healthy people with chronic paraplegia are at risk for cardiovascular disease and qualify for lipid-lowering TLI. Updated guidelines of the ATP III have increased the urgency for early risk assessment and intervention.
OBJECTIVE: To examine percentages of persons with chronic paraplegia who qualify for lipid-lowering therapeutic lifestyle intervention (TLI) as assessed by authoritative guidelines. DESIGN: Cross-sectional. SETTING: Academic medical center. PARTICIPANTS: Forty-one subjects (mean age +/- standard deviation, 34+/-11 y) with motor-complete paraplegia (American Spinal Injury Association grade A or B) at T6-L1 levels for greater than 2 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Percentages of subjects qualifying for TLI were independently assessed and then compared using National Cholesterol Education Project Adult Treatment Panel (ATP) II (1994) and ATP III (2002) Guidelines. RESULTS: A total of 34.1% of subjects qualified for intervention based on the ATP II Guidelines and 63.4% based on ATP III (chi1(2) test=4.53; 2-tailed, P=.003). Seventy-six percent (31/41) of study participants had high-density lipoprotein cholesterol levels below the high-risk criterion of 40 mg/dL established by ATP III. Almost one third of subjects had hypertension, and 34.1% satisfied criteria for diagnosis of the metabolic syndrome. CONCLUSIONS: A high percentage of young, apparently healthy people with chronic paraplegia are at risk for cardiovascular disease and qualify for lipid-lowering TLI. Updated guidelines of the ATP III have increased the urgency for early risk assessment and intervention.
Authors: Mark S Nash; Suzanne L Groah; David R Gater; Trevor A Dyson-Hudson; Jesse A Lieberman; Jonathan Myers; Sunil Sabharwal; Allen J Taylor Journal: J Spinal Cord Med Date: 2019-06-10 Impact factor: 1.985
Authors: Mark S Nash; Suzanne L Groah; David R Gater; Trevor A Dyson-Hudson; Jesse A Lieberman; Jonathan Myers; Sunil Sabharwal; Allen J Taylor Journal: Top Spinal Cord Inj Rehabil Date: 2018