Celiac.com 02/13/2023 - Because earlier studies have been small, or relied on sources with limited socio-demographic and lifestyle data, there's conflicting information associating celiac disease with a higher risk of cardiovascular disease.
Prior studies examining the ties between celiac disease and cardiovascular disease have often omitted traditional cardiovascular risk factors, such as blood pressure or serum total cholesterol, despite research showing healthier cardiovascular profiles in people with celiac disease.
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A team of researchers recently set out to investigate whether people with celiac disease are at increased risk of cardiovascular disease, including ischaemic heart disease, myocardial infarction, and stroke. The research team included Megan Conroy, Naomi Allen, Ben Lacey, Elizabeth Soilleux and Thomas Littlejohns. They are variously affiliated with theNuffield Department of Population Health, University of Oxford, Oxford, UK; the UK Biobank, Stockport, UK; and the Department of Pathology, University of Cambridge, Cambridge, UK.
For their prospective analysis of a large group study, they turned to the UK Biobank database. From between 2006 and 2010, they pulled data on nearly 470,000 adults, just under 2,100 of whom had celiac disease. Participants were aged 40-69 years from England, Scotland, and Wales, and without cardiovascular disease at baseline.
The team focused on the relative risk of cardiovascular disease, ischaemic heart disease, myocardial infarction, and stroke in people with celiac disease compared with people who do not have celiac disease, and used Cox proportional hazard models to determine risk levels.
Over an average follow-up of about 12.5 years, the team found nearly 41,000 cardiovascular disease events, with about 220 events in celiac patients.
Celiacs were less likely to smoke or have traditional cardiovascular risk factors, such as systolic blood pressure, total cholesterol, high body mass index. Even so, they had a higher rate of cardiovascular disease, than their non-celiac peers.
Participants with celiac disease had an incidence rate of 9.0 cardiovascular disease cases per 1,000 person years compared with 7.4 per 1,000 person years in non-celiacs.
The team connected celiac disease to an increased risk of cardiovascular disease, even adjusted for lifestyle factors. The connection was stronger after further adjusting for other cardiovascular risk factors.
The team found similar connections between ischaemic heart disease and myocardial infarction, but noted fewer stroke events, and saw no evidence of a connection between celiac disease and risk of stroke.
People with celiac disease had a fewer traditional cardiovascular risk factors, but still had a higher risk of developing cardiovascular disease than non-celiacs.
Based on these findings, cardiovascular risk scores used in clinical practice may not adequately account for a the higher risk among celiacs. Ideally, this study will help people with celiac disease and their clinicians to improve their awareness regarding the higher cardiovascular risks, and to take relevant precautionary action.
Still, more research is needed to improve our understanding of these connections.
Read more at BMJ Medicine
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