Cardiovascular disease (CVD) is the number one cause of death of persons with chronic spinal cord injury (SCI). One of the main reasons for this is the unfavorable cholesterol profiles that develop among these patients—after they leave rehab.

One study in 2008 shows that during inpatient rehabilitation, HDL (good cholesterol) increased, but more importantly the TC/HDL ratio (a stronger predictor of coronary heart disease than HDL) showed a decrease.

Triglyceride profiles also decreased during rehab, even more so in individuals with incomplete lesions. LDL (bad cholesterol) decreased in paraplegics and slightly increased in tetraplegics. These findings might be explained by the large difference in physical activity before and after the start of rehabilitation, as well as between paraplegics and tetraplegics and complete and incomplete.

Unfortunately for the individuals involved, the favorable changes noted during inpatient rehabilitation were lost by one year post-discharge. Body mass index (BMI) was the most important predictor of unfavorable cholesterol profiles. A high BMI was associated with higher concentrations of total cholesterol, triglycerides, and LDL, a lower HDL concentration, and subsequently a higher TC/HDL ratio. These participants’ lower HDLs were significantly related to their decreased physical activity.

Several risk factors like cigarette smoking, obesity, decreased physical activity, and genetics are associated with unfavorable cholesterol panels. The authors concluded that it is very important for individuals with spinal cord injuries to increase their physical activity as well as monitor their dietary intake. Since not everyone with a spinal cord injury can increase physical activity substantially, dietary intake is even more important for them.

For further information, refer to “Prospective Analysis of Lipid Profiles in Persons with a Spinal Cord Injury During and One Year after Inpatient Rehabilitation;” Sonja de Groot PhD, Annet J. Dallmeijer PhD, Marcel W. Post PhD, Edmond L. Angenot MD, Rita J. van den Berg-Emons PhD, and Luc H. van der Woude PhD; Archives of Physical Medicine and Rehabilitation, Volume 89(3), March 2008.