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Risk of vascular disease in adults with diagnosed coeliac disease: a population-based study
J West1, R F A Logan, T R Card
1Division of Epidemiology and Public Health, Medical School, Queen's Medical Centre, University of Nottingham, Nottingham, UK. joe.west@nottingham.ac.uk
Insights
Individuals with coeliac disease show lower rates of hypertension and high cholesterol. However, risks for myocardial infarction and stroke were not significantly different, suggesting further research on gluten-free diets and cardiovascular health is needed.
Area of Science:
- Gastroenterology
- Cardiology
- Epidemiology
Background:
- Coeliac disease is associated with lower blood pressure, cholesterol, and body mass, suggesting potential cardiovascular benefits.
- Research is needed to confirm if these factors translate to reduced vascular disease risk in coeliac patients.
Purpose of the Study:
- To investigate the association between coeliac disease and the risk of developing major vascular diseases.
- To compare the prevalence of hypertension, hypercholesterolaemia, atrial fibrillation, myocardial infarction, and stroke in adults with and without coeliac disease.
Main Methods:
- A cohort study identified 3,790 adults with diagnosed coeliac disease and 17,925 matched controls from the General Practice Research Database.
- Odds ratios and hazard ratios were calculated to assess the risk of specific vascular conditions, including hypertension, hypercholesterolaemia, atrial fibrillation, myocardial infarction, and stroke.
Main Results:
- Adults with coeliac disease had a significantly lower likelihood of diagnosed hypertension (OR 0.68) and hypercholesterolaemia (OR 0.58) compared to controls.
- A slightly increased odds ratio for atrial fibrillation (OR 1.26) was observed in coeliac disease patients.
- Hazard ratios for myocardial infarction (0.85) and stroke (1.29) did not show substantial differences between groups.
Conclusions:
- Coeliac disease is linked to a lower prevalence of hypertension and hypercholesterolaemia in adults.
- While myocardial infarction and stroke rates were similar, the findings highlight the importance of understanding the impact of gluten-free diets on cardiovascular risk factors.
- Further research is recommended to determine the effect of dietary interventions on cardiovascular health in coeliac disease patients before implementing widespread screening programs.
Background:
It has been suggested that vascular disease mortality may be reduced in coeliac disease because of lower levels of blood pressure, cholesterol and body mass.
Aim:
To examine whether people with coeliac disease are at reduced risk of various vascular diseases.
Methods:
We identified 3,790 adults with diagnosed coeliac disease and 17,925 age- and sex-matched controls in the General Practice Research Database. We estimated odds ratios for diagnosed hypertension, hypercholesterolaemia and atrial fibrillation and hazard ratios for myocardial infarction and stroke.
Results:
Adults with coeliac disease, compared with controls, were less likely to have had a diagnosis of hypertension [11% vs. 15%, odds ratio 0.68 (95% confidence interval: 0.60-0.76)] or hypercholesterolaemia [3.0% vs. 4.8%, odds ration 0.58 (95% confidence interval: 0.47-0.72)] but slightly more likely to have had atrial fibrillation [2.1% vs. 1.7%, odds ratio 1.26 (95% confidence interval: 0.97-1.64)]. The hazard ratio for myocardial infarction was 0.85 (95% confidence interval: 0.63-1.13), while the hazard ratio for stroke was 1.29 (95% confidence interval: 0.98-1.70).
Conclusions:
Although rates of myocardial infarction and stroke were not substantially different, adults with coeliac disease do have a lower prevalence of hypertension and hypercholesterolaemia compared with the general population. The effect of a gluten-free diet on cardiovascular risk factors should be determined before any screening programmes for coeliac disease are instituted.
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