Inflammatory Bowel Disease and Cardiovascular Disease
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Abstract
Inflammatory bowel diseases (IBDs) are immune-mediated inflammatory conditions causing inflammation of the gastrointestinal tract. A range of medical treatment options are used to treat IBD-related inflammation including biologic tumor necrosis factor (TNF) antagonists. IBD prevalence is growing with patients increasingly older and more comorbid. Globally, cardiovascular diseases remain the leading cause of morbidity and mortality. IBD patients are at higher risk of cardiovascular disease, but this does not appear to be conferred by traditional risk factors such as hyperlipidemia and obesity. Appreciation of the relationship between IBD, cardiovascular disease, and inflammation is, therefore, of clinical importance. TNF-α is a key pro-inflammatory cytokine in the development of IBD-related inflammation, hypertension, and cardiovascular disease. Data suggest that commonly prescribed TNF antagonists may mitigate the increased cardiovascular risk in IBD patients. It is unclear if this is a direct effect of TNF antagonism or reflects better control of inflammation. Future research should focus on an improved understanding of the cardiovascular impact of IBD-related inflammation, the risk of adverse outcomes, and the potential effects of IBD treatment on cardiovascular risk profiles. This knowledge should allow better risk stratification when selecting treatment options, contributing to our goal of personalizing the approach to IBD treatment.
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