Higher CVD risk in IBD not explained by traditional risk factors

Last Updated: 2018-11-14

By Will Boggs MD

NEW YORK (Reuters Health) - Traditional cardiovascular risk factors are not increased in patients with inflammatory bowel disease (IBD), despite their higher risk of cardiovascular disease (CVD), researchers from Denmark report.

"The increased risk of cardiovascular disease in patients with IBD may not simply be explained by traditional cardiovascular risk factors, but rather by chronic systemic inflammation," Dr. Kristine H. Allin of the Center for Clinical Research and Prevention at Bispebjerg and Frederiksberg Hospital, in Copenhagen, Denmark, told Reuters Health by email.

Previous studies have found increased risks of cerebrovascular events and ischemic heart disease among patients with IBD, but it remains unclear how patients with the disorder should be counseled regarding risk factor modification.

Dr. Allin's team used data from the Copenhagen General Population Study and the Danish National Patient Register to evaluate the cardiovascular risk profile in patients with IBD as compared to the general population.

The rate of CVD diagnosis was significantly higher among individuals with IBD (13.2%) than in the general population (10.9%), the researchers report in the Journal of Crohn's and Colitis, online October 13.

Surprisingly, traditional cardiovascular risk factors were not increased among IBD patients. Plasma lipid levels, plasma glucose levels and anthropometric measures did not differ between the groups, and patients with IBD had blood pressure levels marginally lower than those in the general population.

In contrast, patients with IBD had significantly higher levels of plasma high-sensitivity C-reactive protein (hs-CRP) and fibrinogen, with both levels even higher in IBD patients who developed CVD than in those who did not.

These differences persisted after adjusting for smoking, age at examination, sex, physical activity and alcohol consumption.

"Elevated traditional cardiovascular risk factors, such as hyperlipidemia or hypertension, should still be treated according to the general guidelines for cardiovascular risk management," Dr. Allin said. "However, further studies should examine the impact of controlling inflammation in patients with IBD on their risk of developing cardiovascular disease, as well as which IBD medications are most effective at doing so."

Dr. William H. Frishman from New York Medical College/Westchester Medical Center, in Valhalla, New York, who recently reviewed the link between IBD and CVD, agreed in an email to Reuters Health that "cardiovascular risk should be treated the same way in patients with IBD" as in others.

"Some of the drugs used for inflammatory bowel disease are actually protective because they contain aspirin," said Dr. Frishman, who was not involved in the study.

SOURCE: https://bit.ly/2TeatIQ

J Crohns Colitis 2018.