The risk of cardiovascular complications in inflammatory bowel disease
- PDF / 935,048 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 13 Downloads / 208 Views
REVIEW ARTICLE
The risk of cardiovascular complications in inflammatory bowel disease Piotr Czubkowski1 · Marcin Osiecki1 · Edyta Szymańska1 · Jarosław Kierkuś1 Received: 4 April 2020 / Accepted: 15 June 2020 © The Author(s) 2020
Abstract Inflammatory bowel disease (IBD) is a chronic, relapsing disease of unknown etiology involving gastrointestinal tract. IBD comprises two main entities: ulcerative colitis and Crohn’s disease. Several studies showed increased risk of cardiovascular complications in chronic inflammatory disorders, especially during IBD relapses. Endothelium plays a role in physiologic regulation of vascular tone, cell adhesion, migration and resistance to thrombosis. Also, its dysfunction is associated with increased risk of atherosclerosis development. There are several potential links between chronic IBD-related inflammatory processes and the risk of cardiovascular disease, but insight into pathogenetic pathways remains unclear. We present the current concepts and review of adult and pediatric studies on the risk of CVD in IBD. Keywords Inflammatory bowel disease · Endothelial dysfunction · Ischemic heart disease · Atherosclerosis
Introduction Cardiovascular diseases (CVD) are the major causes of mortality and morbidity worldwide, responsible for more than 4 million deaths in Europe each year [1]. The most common conditions are coronary heart disease and stroke strictly linked with classic CVD risk factors and health behaviors. The greatest challenge is continuous rise in the prevalence of obesity, arterial hypertension and diabetes. Individuals with inflammatory bowel diseases (IBD), ulcerative colitis (UC) or Crohn’s disease (CD) present with lower prevalence of classic CVD risk factors, like high BMI or lipid disturbances, compared to general population. Moreover, they typically enter the healthcare system at an earlier age, which potentially carries opportunities for effective early prophylaxis of CVD [2]. Therefore, “expected” lower cardiovascular morbidity and mortality are contradictory to “observed” higher prevalence; thus, IBD should be considered as a non-traditional risk factor for CVD in specific subsets of patients [3].
* Edyta Szymańska [email protected] 1
Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Childrens’ Memorial Health Institute, Warsaw, Poland
Moreover, the overall risk of serious cardiovascular events was related to IBD activity with highest risk during flares and periods of persistent activity [4]. There is increasing incidence of IBD in children and adults. The highest pediatric rates are in Europe with 23/100,000 persons per years [5], but the prevalence in newly industrialized countries in Asia, Middle East and Africa is increasing as well [6]. This “paradox” which may be also observed in other chronic inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematous [7–9] hypothetically is linked with negative impact of global inflammation on arterial stiffening [10]. Recent findings have de
Data Loading...
