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Vinculum of Cardiovascular Disease and Inflammatory Bowel Disease: A Narrative Review
Ashujot Kaur Dang1, Daniel A Gonzalez2, Rajeswar Kumar3
1Research, Government Medical College, Patiala, Patiala, IND.
Insights
Inflammatory bowel disease (IBD) significantly increases cardiovascular disease (CVD) risk through mechanisms like immune dysregulation. Managing IBD and adopting dietary strategies are key for reducing CVD complications.
Area of Science:
- Gastroenterology
- Cardiology
- Immunology
Background:
- Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CrD), is a chronic inflammatory condition with significant systemic implications.
- Growing evidence links IBD to increased risks of cardiovascular diseases (CVD), including ischemic heart disease, heart failure, and stroke.
Purpose of the Study:
- To elucidate the complex pathological mechanisms connecting IBD and CVD.
- To review clinical evidence supporting and refuting the IBD-CVD link in both pediatric and adult populations.
- To highlight current and future therapeutic and preventive strategies for managing CVD risk in IBD patients.
Main Methods:
- Comprehensive literature review of recent studies on IBD and CVD.
- Analysis of pathological pathways such as immune dysregulation, endothelial dysfunction, arterial stiffness, and gut dysbiosis.
- Evaluation of clinical data across pediatric and adult IBD cohorts.
Main Results:
- Identified shared pathophysiological mechanisms linking IBD and CVD.
- Reviewed conflicting clinical findings regarding the association between IBD and cardiovascular outcomes.
- Confirmed the importance of disease remission and dietary interventions in mitigating CVD risk.
Conclusions:
- IBD poses a significant CVD risk, mediated by interconnected pathological pathways.
- Current management focuses on IBD remission and diet, but further strategies are needed.
- Exploration of novel preventive and therapeutic methods, particularly for arterial thromboembolic disease (ATED) during active flares, is crucial.
Abstract:
Inflammatory bowel disease (IBD), comprising of ulcerative colitis (UC) and Crohn's disease (CrD), is a chronic relapsing-remitting inflammation of the bowel with extraintestinal involvement. Numerous studies published in the last decade have underlined the dangerous cardiovascular disease (CVD) outcomes of IBD, such as ischemic heart disease, heart failure, and stroke, and the need for better therapeutic and prognostic strategies. This article elucidated the pathological web of mechanisms that link IBD with CVD, such as immune dysregulation, endothelial dysfunction, arterial stiffness, and dysbiosis, with a comprehensive review of clinical studies standing for and against the notion in pediatric and adult populations. The current treatment and prevention aim at disease remission and dietary strategies shown to reduce the CVD risk. Exploration of other supplemental preventive and treatment methods, especially during active flares of disease, to reduce the risk of arterial thromboembolic disease (ATED) is the need of the hour.
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