Chronic inflammation is a contributing factor to cardiovascular disease (CVD). For this reason, patients with Inflammatory Bowel Disease (IBD) need to be aware of the heart health risks associated with IBD—even though the inflammation in IBD is located in the intestines.
Heart Attack Risk and IBD
A study published in March 2018 in the Journal of the American College of Cardiology concluded that IBD increases the likelihood of a heart attack—and, surprisingly, that young IBD patients face a higher risk.
The study used IBM Explorys (a large database of electronic medical records) to review medical data from more than 17 million patients aged 18 to 65, drawing from 26 U.S. healthcare systems. It is one of the largest studies examining the relationship between IBD and heart attacks and adjusted for traditional heart disease risk factors such as age, blood pressure, and smoking.
The results revealed that the 1.2% of patients with IBD (those with Crohn’s and colitis) were approximately 23% more likely to have a heart attack than the patients without IBD. The study concluded this increased risk is independent of factors like smoking, diabetes, high blood pressure, and high cholesterol.
The study also found that younger patients between ages 18 and 24 had a much higher risk of heart attack when compared to patients in the same age group without IBD. In fact, the risk for IBD patients in this age group is nine times higher. Because young people are not likely to have heart attacks, the difference in risk between IBD youths and non-IBD youths is significant.
Interestingly, they also found that people with IBD were more prone to developing diabetes, high blood pressure, and high cholesterol than people without IBD. All of these are risk factors for heart disease.
Why Does IBD Increase the Risk of Heart Disease?
While researchers are still studying the link between cardiovascular disease and IBD, the main hypothesis is that the systemic inflammation from IBD plays a major role. Researcher suggest that the inflammation leads to oxidative stress and elevated levels of inflammatory cytokines such as tumor necrosis factor-α (TNF-α). In turn, this can produce changes in smooth muscle cells (such as the muscles of the heart) and trigger mechanisms that contribute to atherosclerosis (plaque buildup) and CVD.
Heart Health Tips for IBD Patients
As a patient with IBD, you should take steps to manage the risk of CVD and heart attacks.
Make sure you speak with your doctor about heart attack risks, and make sure you are regularly screened for indicators of CVD. Likewise, take your symptoms seriously—especially if you experience chest pain.
If you aren’t taking anti-inflammatory medications for IBD, talk about these with your doctor. Many IBD treatments work by reducing inflammation in the intestines, and because inflammation is thought to increase the risk of CVD, it’s important to decrease the inflammation from IBD as much as possible.
You can also decrease your risk of a heart attack by following a generally heart-healthy lifestyle: get adequate sleep and at least 30 minutes of exercise per day. Follow a balanced, heart-healthy diet with plenty of vegetables, and moderate your intake of cholesterol and sodium, contributors to high cholesterol and blood pressure.
Panhwar M., Mansoor E., Al-Kindi S., Cooper G., Ginwalla M. (2018). Risk of Myocardial Infarction in Patients with Inflammatory Bowel Disease. Journal of the American College of Cardiology, 71(11). A183. Retrieved from https://doi.org/10.1016/S0735-1097(18)30724-1
Wu, P., Jia, F., Zhang, B., & Zhang, P. (2017). Risk of cardiovascular disease in inflammatory bowel disease. Experimental and Therapeutic Medicine, 13(2), 395–400. http://doi.org/10.3892/etm.2016.3966