Suppression of proatherogenic inflammatory cytokines as a therapeutic countermeasure to CVD risks accompanying SCI

Chronic spinal cord injury (SCI) is associated with an increased prevalence of isolated cardiovascular disease (CVD) risks, risk clustering, and cardiometabolic disease. Long-established risks of abdominal obesity, atherogenic dyslipidemia, and impaired glucose tolerance have been commonly reported after SCI, but more recent reports have focused on risks imposed by sustained elevation of proatherogenic inflammatory cytokines. Chronically elevated plasma cytokines are now considered instigators as well as markers of atherogenesis, making both persistent nonspecific subclinical inflammation and inflammatory flares from musculoskeletal disorders, soft tissue injury, and multisite infections relevant to CVD progression after SCI. Various prescription and nonprescription medications effectively reduce the impact of inflammatory cytokines on disease progression in persons without disability who have elevated CVD risks. As some of these agents provide primary and secondary prevention with established cost-effectiveness, these products may have unique utility in effectively managing all-cause CVD after SCI.