The Gut-Heart Connection: Unraveling Cardiovascular Risks in Celiac Disease

Celiac disease (CD) is a chronic autoimmune enteropathy triggered by gluten ingestion in genetically susceptible individuals. While primarily affecting the gastrointestinal tract, CD has increasingly been associated with a spectrum of extraintestinal manifestations, especially cardiovascular complications. This review aims to synthesize the current evidence on the risk of cardiovascular disease in individuals with CD to better understand the clinical implications of this association. Patients with CD may have an increased risk of cardiovascular disease, particularly in cases of delayed diagnosis or poor adherence to a gluten-free diet. Subclinical myocardial dysfunction, endothelial dysfunction, and an increased incidence of atrial fibrillation and venous thromboembolism have been reported. Treatment of CD with gluten abstinence appears to mitigate some cardiovascular risks, although evidence remains inconclusive. Emerging data suggest a complex interplay between CD and cardiovascular health, underscoring the importance of early diagnosis, comprehensive risk assessment, and multidisciplinary management. Further prospective studies are warranted to clarify causality, identify high-risk subgroups, and evaluate the long-term impact of dietary intervention on cardiovascular outcomes in CD.