Inflammatory bowel disease may increase risk of heart failure

Inflammatory bowel disease (IBD) is associated with a slightly increased risk of heart failure up to 20 years after diagnosis, according to a comprehensive registry study from Karolinska Institutet in Sweden published in the European Heart Journal.

The researchers analyzed the risk of heart failure in over 80,000 patients with inflammatory bowel disease—Crohn’s disease, ulcerative colitis or unclassified IBD—compared with 400,000 people from the general population, as part of the ESPRESSO study.

The results show that people with IBD have a 19% increased risk of developing heart failure up to 20 years after diagnosis. This corresponds to one extra heart failure case per 130 IBD patients in those 20 years, and the risk increase was seen regardless of the type of IBD. The highest risk of heart failure was seen in older patients, people with lower education and people with pre-existing cardiovascular-related disease at IBD diagnosis.

“Both health care providers and patients should be aware of this increased risk, and it’s important that cardiovascular health is properly monitored,” says the study’s first author Jiangwei Sun, researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “We hope the results will raise the awareness of health workers as to the increased risk of heart failure in individuals with IBD and contribute to new guidelines for cardiovascular disease management in IBD patients.”

The researchers also analyzed the risk of heart failure in IBD patients compared to their siblings without IBD. In these sibling analyses, the risk increase was slightly lower, 10%, suggesting that genetics and early environmental factors shared within families may play a role.

“We don’t know if there is a causal relationship, but we will continue to explore genetic factors and the role of IBD medications and disease activities on the risk of heart failure,” says the study’s senior author Professor Jonas F. Ludvigsson from the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

The study was conducted in collaboration with researchers at Örebro University, Gothenburg University and Uppsala University in Sweden.