Evidence-based and heuristic approaches for customization of care in cardiometabolic syndrome after spinal cord injury

Mark S. Nash, Rachel E. Cowan, Jochen Kressler

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Component and coalesced health risks of the cardiometabolic syndrome (CMS) are commonly reported in persons with spinal cord injuries (SCIs). These CMS hazards are also co-morbid with physical deconditioning and elevated pro-atherogenic inflammatory cytokines, both of which are common after SCI and worsen the prognosis for all-cause cardiovascular disease. This article describes a systematic procedure for individualized CMS risk assessment after SCI, and emphasizes evidence-based and intuition-centered countermeasures to disease. A unified approach will propose therapeutic lifestyle intervention as a routine plan for aggressive primary prevention in this risk-susceptible population. Customization of dietary and exercise plans then follow, identifying shortfalls in diet and activity patterns, and ways in which these healthy lifestyles can be more substantially embraced by both stakeholders with SCI and their health care providers. In cases where lifestyle intervention utilizing diet and exercise is unsuccessful in countering risks, available pharmacotherapies and a preferred therapeutic agent are proposed according to authoritative standards. The over-arching purpose of the monograph is to create an operational framework in which existing evidence-based approaches or heuristic modeling becomes best practice. In this way persons with SCI can lead more active and healthy lives.

Original languageEnglish (US)
Pages (from-to)278-292
Number of pages15
JournalJournal of Spinal Cord Medicine
Volume35
Issue number5
DOIs
StatePublished - Sep 1 2012

Keywords

  • Atherogenesis
  • Drug therapy
  • Exercise therapy
  • Metabolic cardiovascular syndrome
  • Nutrition therapy
  • Paraplegia
  • Spinal cord injuries
  • Tetraplegia

ASJC Scopus subject areas

  • Clinical Neurology

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