Cardiovascular Risk Profile Among Patients With Inflammatory Bowel Disease: A Population-based Study of More Than 100
Julie Aarestrup1, Tine Jess1, Camilla J Kobylecki2
1Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark.
Insights
Patients with inflammatory bowel disease have higher cardiovascular disease risk, but not due to traditional factors. Chronic inflammation, not cholesterol, appears to be the key driver of this increased cardiovascular risk.
Area of Science:
- Cardiovascular Health
- Gastroenterology
- Immunology
Background:
- Inflammatory bowel disease (IBD) is linked to increased cardiovascular disease (CVD) risk.
- The specific cardiovascular risk factors contributing to this association are not fully understood.
Purpose of the Study:
- To compare the cardiovascular risk profile of IBD patients with the general population.
- To identify whether traditional or non-traditional risk factors explain the elevated CVD risk in IBD.
Main Methods:
- Analysis of 108,789 participants from the Copenhagen General Population Study.
- Inclusion of 1,203 individuals with prevalent IBD (Crohn's disease and ulcerative colitis).
- Assessment of traditional (lipids, glucose, BMI, blood pressure) and non-traditional (inflammatory markers) risk factors.
Main Results:
- IBD patients did not exhibit increased traditional cardiovascular risk factors; cholesterol levels were even lower.
- Higher levels of inflammatory markers, such as high-sensitivity C-reactive protein, were observed in IBD patients.
- Despite lower traditional risk, IBD patients have a higher incidence of cardiovascular diseases.
Conclusions:
- The heightened CVD risk in IBD patients is likely attributable to chronic systemic inflammation.
- Cardiovascular prevention strategies in IBD may need to prioritize inflammation management over traditional risk factor control.
Background And Aims:
Patients with inflammatory bowel disease have increased risks of cardiovascular diseases, but the role of traditional and non-traditional cardiovascular risk factors remains unclear. We investigated if the cardiovascular risk profile differs between patients with inflammatory bowel disease and individuals in the general population.
Methods:
We included a population of 108789 participants from the Copenhagen General Population Study of individuals of Danish descent aged 20-100 years. The population included 1203 individuals with prevalent inflammatory bowel disease [347 with Crohn's disease and 856 with ulcerative colitis]. The cardiovascular risk profile was assessed by traditional risk factors [plasma lipids and glucose, body composition measures, and blood pressure] and non-traditional risk factors [inflammatory markers and biomarkers of liver and pancreas function].
Results:
Even though patients with inflammatory bowel disease more frequently are diagnosed with cardiovascular diseases, traditional cardiovascular risk factors were not increased. Indeed, patients with inflammatory bowel disease had slightly lower plasma levels of total cholesterol and low-density lipoprotein cholesterol. Levels of inflammatory markers, particularly high-sensitivity C-reactive protein, were higher in individuals with versus without a diagnosis of inflammatory bowel disease, when assessed at a random point in time during the disease course.
Conclusions:
The increased risk of cardiovascular diseases in patients with inflammatory bowel disease may be linked to chronic systemic inflammation rather than to traditional cardiovascular risk factors. Further studies need to examine whether cardiovascular-preventive strategies should focus on optimising management of inflammation in patients with inflammatory bowel disease rather than focusing on traditional cardiovascular risk factors.
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