Related Experiment Video
Updated: Aug 2, 2025
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Cardiovascular risk profiles in patients with inflammatory bowel disease differ from matched controls from the
Jasmijn A M Sleutjes1, C Janneke van der Woude1, P J Pepijn Verploegh1
1Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40 Na-6, 3015 GD, PO Box 2040, Rotterdam, The Netherlands.
Insights
Patients with inflammatory bowel disease (IBD) face a higher risk of cardiovascular events, despite lower traditional risk factors. Standard risk scores may underestimate their actual cardiovascular disease (CVD) risk.
Area of Science:
- Gastroenterology
- Cardiology
- Epidemiology
Background:
- Inflammatory bowel disease (IBD) is linked to an elevated risk of atherosclerotic cardiovascular disease (ASCVD).
- Understanding cardiovascular disease (CVD) risk factors and 10-year risk in IBD patients compared to the general population is crucial.
Purpose of the Study:
- To compare CVD risk factors and 10-year CVD risk in IBD patients versus the general population.
- To evaluate the accuracy of the Systematic COronary Risk Evaluation (SCORE2) algorithm in IBD patients.
Main Methods:
- A cross-sectional study included IBD patients aged ≥45 years and age/sex-matched controls from the Rotterdam Study.
- ASCVD history, CVD risk factors (smoking, hypertension, overweight, hypercholesterolaemia, diabetes, metabolic syndrome), and 10-year CVD risk (SCORE2) were assessed.
- 235 IBD patients were matched with 829 controls.
Main Results:
- IBD patients had a higher incidence of ASCVD events (OR 2.01), including heart failure and coronary heart disease.
- IBD patients exhibited lower odds of overweight and hypercholesterolaemia but higher odds of hypertension, increased waist circumference, and elevated triglyceride levels.
- Mean 10-year CVD risk was 4.0% in IBD patients versus 6.0% in controls.
Conclusions:
- The increased CVD risk in IBD patients appears underestimated by the SCORE2 algorithm.
- Discrepancies arise from differing CVD risk profiles in IBD, including lower hypercholesterolaemia/overweight and higher hypertension/abdominal obesity/hypertriglyceridaemia prevalence.
Aims:
Inflammatory bowel disease (IBD) is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). We compared cardiovascular disease (CVD) risk factors and 10-year risk in IBD patients to the general population.
Methods And Results:
In this cross-sectional study, consecutive IBD patients ≥45 years were included. History of ASCVD and CVD risk factors (smoking, hypertension, overweight, hypercholesterolaemia, diabetes, and metabolic syndrome) were assessed. The Systematic COronary Risk Evaluation (SCORE2) algorithm was used to estimate 10-year CVD risk. One to four age/sex-matched controls were derived from the prospective population-based Rotterdam Study cohort. In total, 235 IBD patients were included {56% women, median age 59 years [interquartile range (IQR) 51-66]} and matched to 829 controls [56% women, median age 61 years (IQR 56-67)]. Inflammatory bowel disease patients experienced ASCVD events more often compared with matched controls [odds ratio (OR) 2.01, 95% confidence interval (CI) 1.23-3.27], specifically heart failure (OR 2.02, 95% CI 1.02-4.01) and coronary heart disease (OR 2.01, 95% CI 1.7-3.13). Inflammatory bowel disease patients showed lower odds of overweight (OR 0.48, 95% CI 0.35-0.66) and hypercholesterolaemia (OR 0.45, 95% CI 0.31-0.65) and higher odds of hypertension (OR 1.67, 95% CI 1.19-2.32), as well as higher waist circumference (+4 cm, P = 0.006) and triglyceride levels (+0.6 mmol/L, P < 0.001) as compared with controls. Mean 10-year CVD risk was 4.0% [standard deviation (SD) ±2.6] in 135 IBD patients vs. 6.0% (SD ±1.6) in 506 controls.
Conclusion:
The increased CVD risk in IBD is discrepant with the 10-year CVD risk estimate. Systematic COronary Risk Evaluation may underestimate CVD risk in IBD patients due to differing CVD risk profiles compared with the general population, including a lower prevalence of hypercholesterolaemia and overweight and a higher prevalence of hypertension, abdominal obesity, and hypertriglyceridaemia.
Related Concept Videos
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD: