Autoimmune Diseases and Cardiovascular Risk
Just last month, a new large population based study came out on whether or not having an autoimmune disease increased your risk of having cardiovascular disease. This was a somewhat monumental study, as there has been widespread thought across the medical community that some autoimmune diseases may increase risk of heart attack and stroke. Autoimmune diseases that tend to affect the blood vessels, such as lupus, scleroderma and rheumatoid arthritis have always been under suspicion, but we are now finding other conditions such as Addison’s Disease and Type 1 Diabetes are also at increased risk.
Cardiovascular Risk
In the study, the researchers looked at 22 million people of all ages. 60% of the patients were women and 40% were men, and the average age at the start of the study was 47 years old. What they found, was that 15% of those with autoimmune diseases developed some form of cardiovascular disease within 6.2 years of follow up. There was no difference in increased risk between men and women. There was an increased risk in those diagnosed with an autoimmune disease at a younger (<55 years old) vs older age.
The cardiovascular diseases that were increased included the following:
- aneurysm
- atrial fibrillation
- supraventricular arrhythmias
- conduction issues in the heart
- heart failure
- ischemic heart disease
- myocarditis and pericarditis
- peripheral arterial disease
- infective endocarditis
- stroke
- transient ischemic attack (TIA)
- valve disorders
- clots (venous and pulmonary clots and emboli)
Those with autoimmune diseases were also more likely to have elevations in blood pressure. This is seen as an increase of up to 20mmHg for systolic blood pressures (the upper number). Atherosclerotic disease, BMI (body mass index) and Type II diabetes were also increased. Though because cardiovascular diseases were increased among all cardiovascular conditions, it is thought that the inflammation, and not atherosclerosis is more to blame for increased risk.
It is also important to note that some conditions, (like infections in the heart) may be more likely in those on immunosuppressive medications for their autoimmune disease.
Associated Autoimmune Diseases
In this study, the researchers studied all forms of autoimmune diseases. They found that any autoimmune disease has the potential to increase cardiovascular risk. The conditions with the highest cardiovascular risk included systemic lupus erythematosus (SLE) and scleroderma. These are more likely to cause damage to the lining of the arteries than other conditions. Addison’s disease and Type 1 diabetes also had a higher risk. This is likely due to their effects on blood sugar and endothelial damage.
Cardiovascular risk was increased regardless of blood pressure, diabetes presence, age, sex or socioeconomic status in those with autoimmune diseases. This leads us to believe that inflammation is the main cause of cardiovascular issues. If this is the case, then reducing inflammation, not lipids or blood pressure specifically, would be more beneficial for reducing cardiovascular risk in those with autoimmune diseases. Some anti-inflammatory medications may help reduce the risk of cardiovascular disease. But it should be noted that steroid medications (such as prednisone) will increase risk of cardiovascular disease.
If you have an autoimmune disease and are concerned about cardiovascular risk, talk to your doctor. Screenings for heart health can be done at any age. If you have questions about how your autoimmune disease may play a role in your cardiovascular health, you can set up an appointment with one of our knowledgeable doctors today.
