Is there a cardiovascular risk in inflammatory bowel diseases?

Inflammatory bowel diseases (IBD) are characterized by an increased thrombembolic risk, given the powerful relation between inflammation and thrombosis. Multiple studies showed that patients with IBD have an up to 3-fold higher risk for developing venous thrombembolic (VTE) complications compared to general population, this risk being more increased in the hospitalized IBD flares. Thus, latest consensus recommendations indicate prophylaxis for VTE in hospitalized patients with active IBD but with no clear indications for the management of IBD outpatients. Regarding atherothrombotic risk (myocardial infarction or stroke), up-to-date data are inconclusive. IBD is associated with subclinical atherosclerosis in patients without clinical manifestations of cardiovascular diseases (CVD). However, the results of major studies assessing the hypothesis that IBD is strongly associated with atherosclerotic macrovascular events prove to be divergent even if they show positive correlations with CVD especially on different subgroup analysis. These facts should lead in the future to more prospective studies with control groups that have the same cardiovascular risk profile as in IBD populations in order to admit definitively that patients with IBD are exposed to an increased cardiovascular risk.