Epidemiology, risk factors and management of cardiovascular diseases in IBD

Abstract

IBD is an established risk factor for venous thromboembolism. In the past few years, studies have suggested that patients with IBD might also be at an increased risk of coronary heart disease and stroke. The increased risk is thought to be similar to the level of risk seen in patients with other chronic systemic inflammatory diseases such as rheumatoid arthritis. The risk of developing these conditions is particularly increased in young adults with IBD, and more so in women than in men. Conventional cardiovascular risk factors are not over-represented in patients with IBD, so the increased risk could be attributable to inflammation-mediated atherosclerosis. Patients with IBD often have premature atherosclerosis and have biochemical and genetic markers similar to those seen in patients with atherosclerotic cardiovascular disease. The role of chronic inflammation in IBD-associated cardiovascular disease merits further evaluation. Particular attention should be given to the increased risk observed during periods of increased disease activity and potential modification of the risk by immunosuppressive and biologic therapies for IBD that can modify the disease activity. In addition, preclinical studies suggest that cardiovascular medications such as statins and angiotensin-converting enzyme inhibitors might also favourably modify IBD disease activity, which warrants further evaluation.

Increased risk of acute arterial events in young patients and severely active IBD: a nationwide French cohort study

“…Several pathophysiological mechanisms, including structural and functional vascular changes, as well as biochemical and genetic changes may be involved in the risk of acute arterial events in patients with IBD 19. Besides an increased carotid intima-media thickness and arterial stiffness,20 21 microvascular endothelial dysfunction was observed in patients with IBD 22.…”

A multicentre Study of Nutrition Risk Assessment in Adult Patients with Inflammatory Bowel Disease Attending Outpatient Clinics

“…Obesity in IBD has been associated with poor disease outcomes and patients with IBD are at increased risk of cardiovascular disease [4,27]. Therefore, provision of weight loss interventions as an adjunctive therapy in these individuals is an area that requires further research.…”

“…This is particularly important as patients with IBD and undernutrition are more likely to present higher levels of adiposity, for the same unit of BMI as healthy controls, are more prone to cardiovascular diseases [26,27] and undernutrition can affect adversely their quality of life and clinical outcomes [28]. In this study, percentage weight loss was determined using the current and last recorded weight.…”

Challenges in the Diagnosis and Management of Inflammatory Bowel Disease in the Elderly

“…These medications are often being taken for cardiopulmonary disease, diabetes, and psychiatric disorders. Though typical risk factors for cardiovascular disease are not elevated in IBD patients, they are more prone to developing atherosclerosis [20]. Additionally, depression affects 23 % of older IBD patients [21].…”