Multiple Sclerosis and Cardiovascular Disease: What's the Link?

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Multiple sclerosis (MS) is best known for the way it damages the nervous system. But MS has also been linked to a higher risk of cardiovascular disease (CVD), including problems like heart attack, stroke, and heart failure. The reasons aren't yet well understood, though they may involve inflammation, shared risk factors, and more.

This article discusses the link between MS and CVD, possible symptoms, and ways to reduce risk.

heart exam

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The Link Between MS and Heart Issues

Several studies have suggested an association between MS and heart disease, and research is ongoing to understand their relationship.

Elevated triglyceride and LDL cholesterol (low-density lipoprotein, considered "bad") levels have been associated with worse MS symptoms and more brain imaging abnormalities. MS has also been associated with higher rates of stroke, heart attack, and death from CVD.

The reasons for this are still being investigated, but scientists have suggested links between inflammation and heart disease as well as genetic mutations associated with MS affecting the heart muscle and CVD risk. In addition, some shared risk factors for MS and heart disease, such as smoking and obesity, may contribute to these findings.

MS and CVD Statistics

A 2020 study looking at over 84,000 people for more than 10 years compared the health of those with and without an MS diagnosis. People with MS were approximately 50% more likely to die from heart disease, 28% more likely to have a heart attack, and 59% more likely to have a stroke.

Types of CVD Linked to MS

MS has been linked to the following types of CVD:

  • Heart attack
  • Stroke
  • Peripheral vascular disease (slow, progressive blood circulation disorder)
  • Heart failure
  • Heart imaging abnormalities

Recognizing Symptoms

It is important to recognize symptoms of CVD, particularly for those who are at increased risk.

  • Heart attack symptoms can include chest discomfort, shortness of breath, weakness, dizziness, and nausea.
  • Arrhythmias can cause light-headedness, fainting, palpitations, and weakness.
  • Heart failure may cause shortness of breath, leg swelling, weight gain, fatigue, and exercise intolerance.
  • Stroke can have variable symptoms, including sudden weakness on one side of the body or face, difficulty speaking, and vision changes.
  • Peripheral vascular disease typically presents with claudication, which is discomfort in the leg muscles with walking that is relieved with rest.

When to See a Healthcare Provider

Stroke and heart attacks require immediate attention. Call 911 and seek emergency medical care for any concerning symptoms such as shortness of breath, chest pain, rapid heart rate, or sudden weakness of one side of the body.

Minimizing Risk

Preventing CVD is important for everyone, but those who are at higher risk of CVD should pay close attention to managing controllable risk factors.

Leading as healthy a lifestyle as possible is the first step. This includes:

  • Eating a healthy diet
  • Stopping smoking
  • Exercising (to the extent of your abilities)

MS can make exercising difficult, but regular exercise that gets the heart rate up, including activities like water aerobics and chair exercises, are beneficial.

In addition to a healthy lifestyle, it's important to ensure that blood pressure, blood sugar, and cholesterol are controlled. Lifestyle can help with high blood pressure, diabetes, and high cholesterol, but medications are often needed.

Other Lifestyle Factors

CVD can also be influenced by under-recognized lifestyle factors, including poor sleep habits and mental health conditions. Make sure to get adequate sleep and prioritize mental health for the best possible outcome.


MS has been associated with higher rates of cardiovascular disease, including stroke, heart attack, death from CVD, and peripheral vascular disease. The reason for this is not yet fully understood but could be related to a combination of factors, including inflammation, genetics, and associated risk factors.

It's important to recognize warning signs of CVD and seek medical attention as necessary. Preventing CVD includes a healthy lifestyle and managing other risk factors, like blood pressure, blood sugar, and cholesterol.

A Word From Verywell

Much remains to be understood about MS, including its relationship with heart disease risk. Addressing risk factors that are common to both CVD and MS, like smoking, sedentary lifestyle, and obesity, can be helpful in both reducing CV risk and improving MS symptoms.

Frequently Asked Questions

  • Does MS increase risk of heart attack?

    Observational studies have found an association of MS and heart attacks. In fact, one 2020 study in England showed that people with a diagnosis of MS were 28% more likely to experience a heart attack than those without MS. While this association exists, it does not necessarily mean that MS is the cause of heart attacks.

  • What are the early symptoms of cardiovascular disease?

    Cardiovascular disease and its risk factors (like high blood pressure and high cholesterol) do not commonly cause symptoms initially. Early signs of blockages in the heart's coronary arteries include decreased exercise tolerance, fatigue, and chest discomfort with exertion.

  • Is someone with MS immunocompromised?

    Multiple sclerosis is an autoimmune disease, meaning that the body's immune system is overactive and inappropriately attacking its own tissues. Medications used to treat MS can cause a weakened immune system, so people taking medications for MS are often considered immunocompromised.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Multiple sclerosis.

  2. Jadidi E, Mohammadi M, Moradi T. High risk of cardiovascular diseases after diagnosis of multiple sclerosis. Mult Scler. 2013;19(10):1336-40. doi:10.1177/1352458513475833

  3. Jakimovski D, Guan Y, Ramanathan M, Weinstock-Guttman B, Zivadinov R. Lifestyle-based modifiable risk factors in multiple sclerosis: review of experimental and clinical findings. Neurodegener Dis Manag. 2019;9(3):149-172. doi:10.2217/nmt-2018-0046

  4. Yang F, Hu T, He K, Ying J, Cui H. Multiple sclerosis and the risk of cardiovascular diseases: A mendelian randomization study. Front Immunol. 2022;13:861885. doi:10.3389/fimmu.2022.861885

  5. Mincu RI, Magda SL, Mihaila S, et al. Impaired cardiac function in patients with multiple sclerosis by comparison with normal subjects. Sci Rep. 2018;8(1):3300. doi:10.1038/s41598-018-21599-0

  6. Palladino R, Marrie RA, Majeed A, Chataway J. Evaluating the risk of macrovascular events and mortality among people with multiple sclerosis in EnglandJAMA Neurol. 2020;77(7):820–828. doi:10.1001/jamaneurol.2020.0664

  7. American Heart Association. Warning signs of a heart attack.

  8. American Heart Association. Heart failure signs and symptoms.

  9. American Heart Association. What are the warning signs of stroke?.

  10. American Heart Association. How to help prevent heart disease at any age.

  11. American Heart Association. Sleep plays a role in heart health.

By Angela Ryan Lee, MD
Angela Ryan Lee, MD, is board-certified in cardiovascular diseases and internal medicine. She is a fellow of the American College of Cardiology and holds board certifications from the American Society of Nuclear Cardiology and the National Board of Echocardiography. She completed undergraduate studies at the University of Virginia with a B.S. in Biology, medical school at Jefferson Medical College, and internal medicine residency and cardiovascular diseases fellowship at the George Washington University Hospital. Her professional interests include preventive cardiology, medical journalism, and health policy.