If you’re living with multiple sclerosis (MS), it’s important to understand how this condition affects your heart. Research shows that people with MS may face a higher risk of heart attacks compared to people without MS.

Since cardiovascular disease causes more deaths than any other health issue in the United States, people with MS should remain vigilant about healthy lifestyle habits and preventive care. A 2023 study found that people with MS are 40 percent to 60 percent less likely than people without MS to seek interventions for cardiovascular concerns. Blood vessel problems can make MS symptoms worse, cause more doctor visits, and even increase the risk of serious heart issues.

In this article, we’ll share seven ways MS can impact your heart health, along with some tips to keep your heart healthy.

1. Changes in Heart Muscle Structure

Even though no studies have demonstrated an association between MS and heart muscle diseases, one study did show that people with MS often have changes in their heart muscles. This suggests they may have undetected heart problems. Cardiomyocytes (heart muscular cells) help keep your heartbeats in a rhythm so your body can pump blood throughout the body. Changes to these cells may keep your heart from working as efficiently as it should, and it may lead to heart failure.

2. Inflammation

MS triggers ongoing inflammation throughout your body. This chronic (long-term) inflammation, along with an increase in pro-inflammatory cytokines (proteins in the immune system), can lead to atherosclerosis (the buildup of plaque in the arteries). Over time, plaque damages blood vessel walls, restricts blood flow to tissues and organs, and raises the risk of blood clots.

3. Blood Pressure Changes

Hypertension (high blood pressure can be a common comorbidity (co-occurring condition) of MS. A 2020 study found that people with MS are at a 25 percent increased risk of developing high blood pressure. Hypertension may increase the risk of hemorrhagic strokes (when a blood vessel in the brain ruptures and bleeds) and heart failure, both of which can be life-threatening.

Some members of MyMSTeam have discussed urgent medical issues related to blood pressure. One member shared that they went to the emergency room because of a high blood pressure: “My blood pressure was 200/100. I saw the cardiologist for several tests. They put me on a new medication, and it’s hard to get used to.”

4. Heart Rhythm Problems

Some people with MS experience arrhythmias (irregular heartbeats). Research suggests this might be due to MS affecting the nervous system’s control over heart rates.

Members of MyMSTeam have discussed having a form of arrhythmia known as atrial fibrillation (AFib): “AFib runs rampant in my family,” one member said. “I had to have two valves replaced at 38. Because of the blood thinners, I can no longer take any MS drugs. Cardiac issues trump everything. But I’m still here!”

5. Reduced Physical Activity

MS symptoms like fatigue and mobility issues can make it harder to stay as active. Less physical activity may lead to type 2 diabetes, metabolic syndrome, increased cardiovascular risks, or other conditions.

6. Medication Considerations

Some treatments for MS may also affect heart health. Side effects of MS medications are usually manageable, but they can vary by formulation and brand. Sometimes, blood tests are used to monitor the course of treatment for any adverse effects.

Interferons, a common type of MS treatment, have been linked to irregular heartbeats and low blood pressure. Other drugs, like fingolimod (Gilenya), can also impact heart rhythm, so people taking these may need to be monitored for any changes to the heart. Mitoxantrone is another treatment option, and its dosage amount is typically limited to mitigate risks of heart damage, or cardiotoxicity.

“I still have ringing in my ears, and my blood pressure is through the roof. Blood pressure is up because of my interferon,” one member wrote. Another member responded, “Yes, my blood pressure is way up from the interferon! I wonder what can be done other than getting off the meds.”

Ask your doctor if your MS medication raises your chances of high blood pressure or other cardiovascular risks. It’s never a bad idea to keep an eye on your blood pressure, especially when you’re trying out a new medication. While some people notice high blood pressure symptoms like double vision or headaches, hypertension often goes under the radar unless you check your blood pressure with a blood pressure cuff.

Since untreated MS itself poses a health risk, your neurologist may encourage you to continue MS medications despite cardiovascular risk factors. Let your health care provider know about any changes so they can help determine your best MS treatment options. Keep in mind that you should never start or stop any MS medications without talking to your doctor first.

How To Keep Your Heart Healthy With Multiple Sclerosis

Many of the recommendations used to slow the disease course of MS can also help ward off heart disease and other health concerns. Keeping up with medical appointments (including dental appointments), getting enough sleep, and joining support groups are just a few tips to stay healthy. Some lifestyle habits can also help you better manage your heart health, including those listed below.

Stay Active

The American Heart Association generally advises 150 minutes per week of physical activity for adults. However, this guideline is only met by 20 percent of adults and teens in the general population. Keep in mind that this guideline may be more challenging for people with MS to follow because of exercise barriers like difficulty moving, muscle weakness, disability, and fatigue.

MyMSTeam members have shared different workout strategies, including water aerobics, modified exercise classes, and exercising on the couch or while lying down. Meeting with a physical therapist can help you find ways to stay active, maintain your independence, and protect your heart.

Eat Heart-Healthy Foods

Try to choose foods that include omega-3 fatty acids to lower your risk of heart problems. Your doctor may advise limiting your sodium intake to keep your blood pressure under control. If MS limits your ability to exercise, following a healthy diet can help prevent excess weight gain that can raise your risk of heart disease. Focus on fresh fruits, vegetables, and high-fiber foods to promote satiety and keep your cholesterol levels down. Always follow up with your health care team before changing your diet or starting a physical activity program.

Avoid Smoking

Exposure to tobacco, either through smoking or being around secondhand smoke, may increase the risk of heart disease by 25 percent to 30 percent. Cigarette smoke can cause plaque to accumulate in the arteries, which may worsen with the inflammation associated with MS.

When To See a Doctor

Contact your health care provider immediately if you experience:

• Chest pain
• Irregular heartbeat
• Unexplained shortness of breath
• Sudden blood pressure changes

Remember, your health care team can help you find the right balance between managing your MS and heart health. Together with your doctor, you can find the best treatment options for you and your specific needs.

Connect With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. Here, more than 216,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Are you living with MS and heart disease? What has helped you manage the two conditions? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.