Inflammatory bowel disease and atherosclerotic cardiovascular disease in U.S. adults-A population-level analysis in the national health interview survey

Am J Prev Cardiol. 2022 Jan 17;9:100316. doi: 10.1016/j.ajpc.2022.100316. eCollection 2022 Mar.

Khurram Nasir 1 2, Isaac Acquah 1 2, Amit K Dey 3, Tanushree Agrawal 1, Syed Zawahir Hassan 1, Kerri Glassner 4, Bincy Abraham 4, Eamonn M M Quigley 4, Ron Blankstein 5, Salim S Virani 6, Michael J Blaha 7, Javier Valero-Elizondo 1 2, Miguel Cainzos-Achirica 1 2, Nehal N Mehta 8


Author information

  • 1Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, MD, United States.
  • 2Center for Outcomes Research, Houston Methodist Research Institute, Houston, MD, United States.
  • 3Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, United States.
  • 4Division of Gastroenterology, Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital, Houston, MD, United States.
  • 5Cardiovascular Imaging Program, Department of Medicine and Radiology, Brigham and Women's Hospital, Boston, MD, United States.
  • 6Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, MD, United States.
  • 7Ciccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins University, Baltimore, MD, United States.
  • 8Section of Inflammation and Cardiometabolic Diseases National Institutes of Health, Bethesda, MD, United States.


Objectives: To evaluate the association between inflammatory bowel disease (IBD) and atherosclerotic cardiovascular disease (ASCVD) and whether this association is modified by age or sex.

Methods: We conducted a cross-sectional analysis using data from the 2015-2016 National Health Interview Survey (NHIS). The exposure of interest was self-reported IBD. The outcome of interest was prevalent ASCVD, which included a history of angina, myocardial infarction or stroke. We used survey-specific descriptive statistics to obtain weighted national estimates for IBD and ASCVD prevalence. Logistic regression models were used to assess the association between IBD and ASCVD, progressively adjusting for demographics and traditional risk factors. Effect modification by age and sex was evaluated.

Results: Among participants with IBD, the age-adjusted prevalence of ASCVD was 12.0% compared to 6.9% among those without IBD (p < 0.001). In multivariable regression analyses IBD was associated with increased odds of having ASCVD, even after adjustment for demographics and traditional risk factors (odds ratio 1.58, 95% CI 1.17-2.13). We found statistically significant interaction by age (p < 0.001) whereby those in the younger age strata had the strongest association (fully adjusted odds ratio among 18- to 44-year-olds 3.35, 95% CI 1.75, 6.40) while the association was null in those ≥65 years. Effect modification by sex was not observed.

Conclusion: Our analysis confirms an independent association between IBD and ASCVD in the U.S., particularly among young adults. Further studies are needed to fully establish a causal relationship between IBD and ASCVD, characterize the mechanisms underlying these associations, and identify tailored opportunities for ASCVD prevention in young and middle-aged adults with IBD.



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