Inflammatory Bowel Disease May Elevate Cardiovascular Disease Risk

Patients with inflammatory bowel disease (IBD) may be at a higher risk of a heart attack, regardless of cardiovascular risk factors, such as high cholesterol, hypertension, and smoking status, according to a study presented at the American College of Cardiology’s 67^th Annual Scientific Session.

The authors suggest that patients aged 18 to 24 years with IBD may be at the highest risk of heart attack, despite being outside of the traditional risk category.

“Younger patients had about 9 times the risk of a heart attack compared to their peers in the same age group [who didn’t have IBD], and this risk continued to decline with age,” lead author Muhammad S. Panhwar, MD, said in a press release. “Our findings suggest that IBD should be considered an independent risk factor for heart disease.”

The CDC estimates that 3 million Americans had Crohn’s disease or ulcerative colitis in 2015, with more than 700,000 new cases diagnosed each year.

Although other studies have suggested a link between inflammatory diseases and a higher risk of heart disease, a connection to IBD has yet to be proven.

In the current study, the researchers analyzed data from medical records for more than 17.5 million patients aged 18 to 65 years who were included in the IBM Explorys database to determine heart attack rates.

In total, there were 21,870 patients with IBD. These patients were more likely to have diabetes, hypertension, high cholesterol, and be smokers compared with those without IBD, according to the study.

Patients with IBD were found to be twice as likely to experience heart attacks compared with patients without IBD, according to the study.

After accounting for age, race, sex, and heart disease risk factors, patients with IBD were 23% more likely to experience a heart attack compared with control patients.

Women 40 years and younger with IBD were also found to be at a higher risk of heart attack compared with age-matched male patients with IBD, according to the study. This trend was not observed in patients with IBD who are 40 years and older.

Younger patients and women with IBD typically experience aggressive disease with frequent flares, indicating high levels of inflammation. The authors said the elevated levels of inflammation in these populations may explain why there was a significantly higher risk of heart attacks, according to the study.

“Our study adds considerably to a growing set of literature highlighting the importance of chronic inflammation in IBD as having a role in the development of heart disease,” Dr Panhwar said.

The authors advise health care providers to rigorously screen patients with IBD for cardiovascular disease to prevent heart attacks and other adverse events.

These findings call for further research into the link between IBD and heart disease, including using anti-inflammatory drugs to manage cardiovascular risk in patients with IBD, according to the study. Additionally, the authors hope that the results will encourage patients with IBD to discuss their risk of cardiovascular disease with their providers.

“The results suggest clinicians should take seriously any symptoms suggestive of heart disease, such as chest pain, in patients with IBD, especially in younger patients,” Dr Panhwar said.