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Inflammatory bowel disease and the risk for cardiovascular disease: Does all inflammation lead to heart disease?
Allison Bigeh1, Alexandra Sanchez2, Camila Maestas1
1Department of Medicine, University of Arizona, Phoenix, AZ, United States.
Insights
Inflammatory Bowel Disease (IBD) patients face increased risks for atherosclerotic cardiovascular disease (ASCVD). Early screening and aggressive risk factor management are crucial for preventing cardiovascular events in this population.
Area of Science:
- Cardiovascular Medicine
- Gastroenterology
- Inflammation Research
Background:
- Inflammation plays a key role in atherosclerotic cardiovascular disease (ASCVD) development.
- The link between Inflammatory Bowel Disease (IBD) and ASCVD risk is not well-established.
- IBD involves chronic intestinal inflammation with potential systemic effects.
Purpose of the Study:
- To investigate the association between Inflammatory Bowel Disease (IBD) and atherosclerotic cardiovascular disease (ASCVD) risk.
- To identify specific cardiovascular risks and influencing factors in IBD patients.
- To highlight the need for cardiovascular risk assessment in IBD management.
Main Methods:
- Review of existing cohort studies and scientific literature.
- Analysis of ASCVD risk factors in IBD populations, including lifestyle and medication effects.
- Examination of cardiovascular event rates (myocardial infarction, stroke, atrial fibrillation, heart failure) in IBD patients.
Main Results:
- IBD patients exhibit an elevated risk for acute myocardial infarction and stroke, particularly women and younger individuals.
- IBD is associated with increased risks of atrial fibrillation and heart failure, especially during active disease flares.
- While some traditional ASCVD risk factors are less prevalent, others like smoking, diabetes, obesity, and certain IBD treatments contribute to cardiovascular risk.
Conclusions:
- All IBD patients, especially younger ones, require screening for ASCVD risk factors.
- Aggressive modification of ASCVD risk factors is essential for IBD patients.
- Further research is needed to develop targeted prevention and treatment strategies for cardiovascular events in IBD, particularly during flares.
Abstract:
Inflammation has a strong role in the development of atherosclerotic cardiovascular disease (ASCVD). Several systemic inflammatory conditions have been linked to an increased risk of ASCVD; however, this has not been well established in Inflammatory Bowel Disease (IBD). IBD is comprised of Ulcerative Colitis and Crohn's disease, both of which involve chronic inflammation of the intestinal tract, often with evidence of systemic involvement. Several ASCVD risk factors such as smoking, diabetes, poor diet and the presence of obesity may increase the risk of ASCVD in patients suffering from IBD, despite a lower prevalence of hypertension and hypercholesterolemia. Medications used to treat IBD and target inflammation, such as steroids, may also accelerate the risk of the risk for ASCVD heart failure while exacerbating ASCVD risk factors. Several studies have demonstrated an elevated risk of acute myocardial infarction and stroke in these patients, most notably in women and in younger patients. Some cohort studies have also suggested a link between IBD and both atrial fibrillation and heart failure, particularly during periods of active flares. All IBD patients, particularly younger individuals, should be screened for ASCVD risk factors with aggressive risk factor modification to reduce the risk of cardiovascular events. Further research is needed to identify how to prevent and treat cardiovascular events that occur in patients with IBD, particularly during active flares.
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