Sinha Tanya, Zain Zukhruf, Bokhari Syed Faqeer Hussain, Waheed Sarosh, Reza Taufiqa, Eze-Odurukwe Anthony, Patel Mitwa, Almadhoun Mohammed Khaleel I Kh, Hussain Azlaan, Reyaz Ibrahim
Medical Education, Tribhuvan University, Kirtipur, NPL.
Family Medicine, Aga Khan University Hospital, Karachi, PAK.
Cureus. 2024 Feb 29;16(2):e55268. doi: 10.7759/cureus.55268. eCollection 2024 Feb.
Inflammatory bowel disease (IBD) presents a complex interplay of chronic inflammation in the gastrointestinal tract and is associated with various extraintestinal manifestations, including cardiovascular complications (CVCs). IBD patients face an elevated risk of CVCs, including coronary artery disease, heart failure, arrhythmias, stroke, peripheral artery disease, venous thromboembolism, and mesenteric ischemia, necessitating comprehensive cardiovascular risk assessment and management. The intricate interplay between chronic inflammation, genetic predisposition, environmental factors, and immune dysregulation likely contributes to the development of CVCs in IBD patients. While the exact mechanisms linking IBD and CVCs remain speculative, potential pathways may involve shared inflammatory pathways, endothelial dysfunction, dysbiosis of the gut microbiome, and traditional cardiovascular risk factors exacerbated by the chronic inflammatory state. Moreover, IBD medications, particularly corticosteroids, may impact cardiovascular health by inducing hypertension, insulin resistance, and dyslipidemia, further amplifying the overall CVC risk. Lifestyle factors such as smoking, obesity, and dietary habits may also exacerbate cardiovascular risks in individuals with IBD. Lifestyle modifications, including smoking cessation, adoption of a heart-healthy diet, regular exercise, and optimization of traditional cardiovascular risk factors, play a fundamental role in mitigating CVC risk. Emerging preventive strategies targeting inflammation modulation and gut microbiome interventions hold promise for future interventions, although further research is warranted to elucidate their efficacy and safety profiles in the context of IBD. Continued interdisciplinary collaboration, advanced research methodologies, and innovative interventions are essential to address the growing burden of CVCs in individuals living with IBD and to improve their long-term cardiovascular outcomes.
炎症性肠病（IBD）呈现出胃肠道慢性炎症的复杂相互作用，并与各种肠外表现相关，包括心血管并发症（CVCs）。IBD患者面临CVCs风险升高，包括冠状动脉疾病、心力衰竭、心律失常、中风、外周动脉疾病、静脉血栓栓塞和肠系膜缺血，因此需要进行全面的心血管风险评估和管理。慢性炎症、遗传易感性、环境因素和免疫失调之间的复杂相互作用可能导致IBD患者发生CVCs。虽然将IBD与CVCs联系起来的确切机制仍属推测，但潜在途径可能涉及共同的炎症途径、内皮功能障碍、肠道微生物群失调以及由慢性炎症状态加剧的传统心血管危险因素。此外，IBD药物，特别是皮质类固醇，可能通过诱发高血压、胰岛素抵抗和血脂异常来影响心血管健康，进一步放大整体CVC风险。吸烟、肥胖和饮食习惯等生活方式因素也可能加剧IBD患者的心血管风险。生活方式的改变，包括戒烟、采用有益心脏健康的饮食、定期锻炼以及优化传统心血管危险因素，在降低CVC风险方面起着至关重要的作用。针对炎症调节和肠道微生物群干预的新兴预防策略有望用于未来的干预措施，尽管需要进一步研究以阐明它们在IBD背景下的疗效和安全性。持续的跨学科合作、先进的研究方法和创新的干预措施对于解决IBD患者中日益增加的CVC负担以及改善他们的长期心血管结局至关重要。
