Tufts University School of Medicine, Boston, MA, USA.
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Dig Dis Sci. 2022 Apr;67(4):1337-1344. doi: 10.1007/s10620-021-06949-9. Epub 2021 Mar 26.
Diverticulitis and cardiovascular disease (CVD) are two highly prevalent disorders sharing common risk factors which are hypothesized to have an inflammatory basis.
To examine the association between history of diverticulitis and risk of incident CVD.
We conducted a prospective cohort study of 43,904 men aged 40 to 75 years without a history of CVD (fatal or nonfatal myocardial infarction and stroke) at enrollment who were followed up from 1986 to 2012 in the Health Professionals Follow-Up Study. Lifestyle factors, dietary intake, and disease information were self-reported biennially or quadrennially. Incident diverticulitis and CVD were confirmed by review of medical records. We used Cox proportional hazard models to calculate age- and multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) of incident CVD. We conducted a stratified analysis according to the presence or absence of CVD risk factors (smoking, hypertension, hyperlipidemia, and diabetes).
We identified 3848 incident cases of CVD during 856,319 person-years of follow-up. Men with diverticulitis had higher incidence of CVD (727 cases per 100,000 person-years) compared to men without diverticulitis [446 cases per 100,000 person-years, multivariate HR of 1.35 (95% CI 1.07-1.70)]. The association of diverticulitis and subsequent CVD appeared more evident among men without known CVD risk factors (HR 4.06, 95% CI 2.04-8.08) compared to those with one or more CVD risk factors (HR 1.27, 95% CI 0.98-1.63).
Diverticulitis may be an independent risk factor of incident CVD, suggesting possible common etiopathogenic mechanisms. Diagnosis of diverticulitis underscores the importance of preventive measures to reduce future CVD.
憩室炎和心血管疾病（CVD）是两种高发疾病，它们具有共同的风险因素，这些因素被认为具有炎症基础。
研究憩室炎病史与新发 CVD 风险之间的关系。
我们对 43904 名年龄在 40 至 75 岁之间、入组时无 CVD（致命或非致命性心肌梗死和中风）病史的男性进行了一项前瞻性队列研究，这些男性在 1986 年至 2012 年期间参加了健康专业人员随访研究。生活方式因素、饮食摄入和疾病信息每两年或四年报告一次。通过审查医疗记录来确认新发憩室炎和 CVD。我们使用 Cox 比例风险模型来计算年龄和多变量调整后的新发 CVD 风险比（HR）和 95%置信区间（CI）。我们根据 CVD 风险因素（吸烟、高血压、高血脂和糖尿病）的存在与否进行了分层分析。
我们在 856319 人年的随访中发现了 3848 例新发 CVD 病例。患有憩室炎的男性 CVD 发病率更高（727 例/100000 人年），而没有憩室炎的男性 CVD 发病率为 446 例/100000 人年，多变量 HR 为 1.35（95%CI 1.07-1.70）。与有一个或多个 CVD 风险因素的男性相比（HR 1.27，95%CI 0.98-1.63），无已知 CVD 风险因素的男性中憩室炎与随后 CVD 之间的关系更为明显（HR 4.06，95%CI 2.04-8.08）。
憩室炎可能是新发 CVD 的独立危险因素，表明可能存在共同的病因发病机制。憩室炎的诊断强调了采取预防措施减少未来 CVD 的重要性。
