Celiac Disease Doubles Risk of Coronary Artery Disease
There is a growing body of evidence showing that systemic inflammation is associated with cardiovascular disease. A new study shows that even low-grade inflammation in the gut can nearly double the risk of coronary artery disease (CAD) in patients with celiac disease.
A team of investigators obtained electronic health records of nearly 22.4 million patients from 13 participating healthcare systems between 1999 and 2003. Of these patients, approximately 25,000 patients had a diagnosis of celiac disease. Compared with a control group that was matched for CAD risk factors, including sex, race, diabetes, high cholesterol, hypertension, and smoking, CAD was more prevalent among patients with celiac disease (9.5% vs 5.6%, respectively).
Celiac disease is a chronic inflammatory condition in which consuming gluten triggers an immune response in the small intestine that, over time, can damage the intestinal lining, causing difficulty digesting food and absorbing nutrients.
The body’s response to gluten “can spill immune mediators into the bloodstream, which can then accelerate the process of atherosclerosis and, in turn, coronary artery disease,” said co-investigator RD Gajulapalli, MD, Cleveland Clinic, in an ACC press release.
The study also found this association to be stronger in patients under the age of 65 years with celiac disease compared with those without celiac disease (4.5% vs 2.4%, respectively. Gajulapalli said the results of this study may have identified a specific patient population with high risk of CAD that clinicians should be aware of, however, “Whether patients with celiac disease will need more intense risk factor modification like in diabetic patients with coronary artery disease will need to be studied,” he said.
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Celiac disease affects an estimated 1 in 133 Americans, but many experts believe the prevalence of this condition is actually much higher, as many cases are underdiagnosed or misdiagnosed. Additionally, many people may have gluten sensitivities but do not have celiac disease.
Until further studies are conducted to confirm this association, clinicians should advise their patients with celiac disease or gluten sensitivity to maintain a healthy lifestyle and be aware of cardiovascular risk factors, Gajulapalli said.
The study—the first of its kind to examine celiac disease and CAD—was presented at the American College of Cardiology (ACC) 2014 Scientific Sessions held March 29-31 in Washington, DC. Gajulapalli said the study was prompted by previous evidence linking celiac disease with cardiac arrhythmias.
- Allison Musante, ELS
Reference
Celiac disease linked to increased risk of coronary artery disease [news release]. Washington, DC: American College of Cardiology. cardiosource.org/en/News-Media/Media-Center/News-Releases/2014/03/Gajulapalli-Celiac-Disease.aspx. Published March 29, 2014. Accessed April 3, 2014.