KU Leuven: Autoimmune diseases increase the risk of cardiovascular disease


About ten percent of the population in affluent regions such as Europe and the United States has been diagnosed with one or more autoimmune diseases. Examples include rheumatoid arthritis, psoriasis, systemic sclerosis, lupus erythematosus, and type 1 diabetes. Previous research has shown that some of these conditions are associated with a higher risk of cardiovascular disease. However, these studies were small or too limited in their design to draw firm conclusions about the need for cardiovascular disease prevention in patients with autoimmune diseases.

That is now changing. At the annual conference of the European Society of Cardiology, organized this weekend in Barcelona, ​​an international research team led by KU Leuven will present the results of a thorough epidemiological study into possible links between nineteen of the most common autoimmune diseases and heart disease. – disease. The results of the study show that patients with autoimmune diseases have a significantly higher risk of developing cardiovascular disease than those who do not have autoimmune disease. The risk is between 1.4 and 3.6 times greater, depending on the autoimmune disease in question. This additional risk is comparable to that of type 2 diabetes, a known risk factor for cardiovascular disease.

Impact on a broad spectrum
In the study, published in The Lancet , the researchers show that the group of 19 autoimmune diseases they studied is responsible for about six percent of cardiovascular events. The increased risk is present across the spectrum of cardiovascular disease: from more classic heart problems (caused by narrowing of the coronary arteries) to infection-related heart disease, heart inflammation, clot formation in the heart and blood vessels, and degenerative heart disease. Thus, the influence of autoimmunity on cardiovascular health appears to be much greater than originally thought.

In addition, the concomitant cardiovascular risk could not be explained by traditional risk factors such as age, gender, socioeconomic status, blood pressure, BMI, smoking, cholesterol and type 2 diabetes. The researchers also found that the concomitant risk is particularly high in patients with autoimmune diseases. who are younger than 55 years of age. This seems to indicate that autoimmune diseases play a particularly large role in causing premature cardiovascular disease, leading to increased disability and a disproportionate loss of life years.

The study used digital health records from the United Kingdom’s Clinical Practice Research Datalink (CPRD), a very large database of anonymized patient data from approximately one-fifth of the current UK population. From 22 million patient records, the researchers compiled a cohort of patients who had recently been diagnosed with one of the 19 autoimmune diseases. They then looked at the incidence of twelve cardiovascular outcomes in subsequent years, and compared them with a matching control group. The risk of developing cardiovascular disease was on average 1.56 greater in patients with one or more autoimmune diseases than in patients without an autoimmune disease. The research also shows that the additional risk increases with the number of different autoimmune diseases in individual patients. Systemic sclerosis, Addison’s disease, lupus, and type 1 diabetes are among the conditions with the highest additional risk.

Take action

Lead researcher Nathalie Conrad:
“There is a need for targeted prevention
measures for these patients.”
“The results show that we need to take action,” said lead researcher Nathalie Conrad of KU Leuven. “We see that the increased risk is comparable to that of type 2 diabetes. Where we use specific measures for diabetes patients to reduce their risk of developing cardiovascular disease, both preventively and during follow-up, it is in patients with a car. -immune diseases not the case.”

Conrad hopes the study can raise awareness among patients with autoimmune diseases and clinicians involved in caring for these patients, including cardiologists, rheumatologists and primary care physicians. “More research is needed to understand why patients with autoimmune disease develop more cardiovascular disease than others. We need to develop targeted prevention measures for these patients and further investigate how we can prevent this.”

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