Cardiovascular disease risk increases if you have autoimmune disorders

In high-income areas like Europe and the United States, 10% of the population has been identified as having one or more autoimmune illnesses.

Examples include type I diabetes, lupus erythematosus, psoriasis, systemic sclerosis, and rheumatoid arthritis. Although earlier studies have suggested links between some of these disorders and a higher risk of cardiovascular disease, these studies were frequently too small and restricted to specific autoimmune or cardiovascular conditions to draw firm conclusions about the necessity of cardiovascular disease prevention among autoimmune disease patients.

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Before now. An international research team led by KU Leuven presented the findings of a thorough epidemiological investigation into potential associations between 19 of the most prevalent autoimmune disorders and cardiovascular disease at the annual congress of the European Society of Cardiology, held this past weekend in Barcelona. According to the study's findings, individuals with autoimmune disease are far more likely than healthy individuals to acquire cardiovascular disease (between 1.4 and 3.6 times higher risk depending on the autoimmune ailment they have). Similar to type 2 diabetes, which is a well-known risk factor for cardiovascular disease, this increased risk is comparable to it. The study demonstrates for the first time that autoimmune illness as a set of disorders is affected by cardiovascular risks rather than specific ailments individually.

The whole cardiovascular disease spectrum

The authors of the study demonstrate that the 19 autoimmune illnesses they looked at account for around 6% of cardiovascular events. Importantly, excess cardiovascular risk was seen across the entire cardiovascular disease spectrum, beyond classical coronary heart disease, including infection-related heart disorders, heart inflammation, as well as thromboembolic and degenerative heart disorders, indicating that the effects of autoimmune disease on cardiovascular health are probably much more widespread than previously believed.

Additionally, conventional cardiovascular risk factors such as age, sex, socioeconomic position, blood pressure, BMI, smoking, cholesterol, and type 2 diabetes did not account for the elevated risk. Another interesting finding is that autoimmune disease may play a significant role in the development of premature cardiovascular disease, which may lead to a disproportionate loss of life years and disability. This excess risk is particularly high in patients with autoimmune disorders under the age of 55.

The UK's Clinical Practice Research Datalink (CPRD), a sizable collection of anonymized patient data from around one-fifth of the country's current population, served as the study's foundation. The researchers created a cohort of patients who had recently been diagnosed with any of the 19 autoimmune illnesses from 22 million medical records. They then compared the incidence of 12 cardiovascular events to a matched control group, using an unparalleled level of granularity made feasible by the extremely vast size of the information.

Patients with one or more autoimmune disorders had a 1.56-fold increased risk of having cardiovascular disease compared to those without autoimmune disease. They also discovered that the excess risk increased with the variety of autoimmune diseases that a patient had. The conditions with the biggest extra risk included type I diabetes, Addison's illness, lupus, and systemic sclerosis.

Need for targeted prevention measures

Nathalie Conrad, the study's primary author, said the findings demonstrate the necessity of taking action. We can observe that the excess risk is similar to type 2 diabetes. We do, however, not have any analogous procedures for patients with autoimmune illnesses, despite the fact that we have particular interventions targeted at diabetes patients to minimize their risk of developing cardiovascular disease (in terms of preventive and follow-up). Conrad refers to the European Society of Cardiology guidelines on the prevention of cardiovascular diseases, which do not yet list autoimmunity as a cardiovascular risk factor (the guidelines only mention some specific disorders, such as lupus) or list any specific preventive measures for individuals with autoimmune disease.

Conrad believes that the study will increase awareness among autoimmune illness patients and physicians who treat them, including those in a wide range of specialities like cardiologists, rheumatologists, and general practitioners. "For these patients, we need to establish tailored preventative strategies." We also need to conduct an additional study to better understand why people with autoimmune disorders are more likely to acquire cardiovascular diseases than other people, as well as how to stop this from happening.

The basic mechanisms of pathophysiology are still not fully understood. "The overall theory is that persistent and systemic inflammation, which is a prevalent factor in autoimmune illnesses, can cause all types of cardiovascular disease," said Conrad. Patients' cardiovascular risk is also probably influenced by the effects of autoimmune disease on connective tissues, tiny blood arteries, and cardiomyocytes, as well as perhaps some of the popular treatments for autoimmunity. This truly has to be looked into in depth.