Cardiovascular Disease Study
Cardiovascular Disease Study
Coronary heart disease (CHD) is a leading cause of death in the spinal cord injured (SCI)
 population, occurring at younger ages than in the able-bodied population. Conventional risk
 factors for CHD include high concentrations of low-density lipoprotein (LDL), low
 concentrations of high-density lipoprotein (HDL), diabetes mellitus (DM), smoking history,
 and family history. Other factors that may influence progression of CHD include C-reactive
 protein (an inflammatory marker), and fibrinogen (a pro-coagulant marker). Individuals with
 SCI with longer duration and greater completeness of injury are more likely to have
 significantly worse carbohydrate tolerance compared to other neurological deficit subgroups.
 Muscle atrophy after SCI is associated with increased insulin resistance. Prolonged
 inactivity has been shown to be associated with hyperinsulinemia and impaired glucose
 tolerance. Body composition changes after SCI to indicate significantly more total body fat
 mass and percent fat and less lean mass compared to able-bodied individuals. Carotid
 intima-media thickness is correlated with atherosclerosis progression and abdominal
 adiposity. Individuals with abdominal adiposity are at a higher risk for CHD, DM,
 hypertension, insulin resistance, and dyslipidemia. Abdominal adiposity and insulin
 resistance are contributors to postprandial lipemia, which may be a more sensitive indicator
 of CHD risk and progression.

 The purpose of this study is to determine the prevalence of conventional risk factors by
 assessing the 10-year risk for CHD, and identify emerging risk factors for CHD in the spinal
 cord injured population. Subjects will have the option to participate in a high fat meal test
 to determine postprandial lipemic responses. Knowledge of this information may be able to
 detect and prevent future cardiovascular events related to CHD.
Inclusion Criteria:

 -  Male 45-75 years old with at least 5 years of SCI

 -  Female 45-50 years old with at least 10 years of SCI

 -  Female 50-75 years old with at least 5 years of SCI

 Exclusion Criteria:

 -  Acute medical illness

 -  Pregnant females

 -  Chronic debilitating disease (i.e., heart disease, pulmonary disease, etc.)

 -  Atrial fibrillation

 -  History of percutaneous coronary angiography with stent placement