Woo Ho Geol, Park Ju-Young, Park Moo-Seok, Song Tae-Jin
Department of Neurology, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Department of Statistics, Yeungnam University, Gyeongsan, Republic of Korea.
Ann Transl Med. 2025 Apr 30;13(2):14. doi: 10.21037/atm-24-218. Epub 2025 Apr 29.
Studies evaluating the association between hemorrhoids and heart failure (HF) have been limited. We aimed to evaluate the association between increased incidence of HF and the presence of hemorrhoids using a population-based longitudinal cohort.
We included 356,033 participants in this study, derived from health screening data collected between 2003 and 2007 from the South Korean health screening cohort database. Hemorrhoid presence was identified as having a minimum of two claims based on the International Classification of Diseases, Tenth Revision (ICD-10) code I84. Propensity score matching (PSM) was used to assign participants to two groups according to the presence and treatment of hemorrhoids. The primary outcome was the incidence of HF, defined as having two or more claims based on the ICD-10 code I50.
Among the participants, the presence of hemorrhoids was observed in 24,363 (6.8%) individuals. Over a median follow-up period of 13.33 years (interquartile range, 10.4-16.26), 55,167 cumulative cases of HF (15.5%) occurred. In multivariate analysis, the group with hemorrhoids consistently showed a higher incidence of HF compared to those without hemorrhoids, both before [hazard ratio (HR): 1.073; 95% confidence interval (CI): 1.028-1.121] and after PSM (HR: 1.073; 95% CI: 1.018-1.131). Regarding surgical procedures/treatments for hemorrhoids, participants who underwent surgical procedures or treatment for hemorrhoids showed a lower incidence of HF before PSM (HR, 0.919; 95% CI: 0.845-1.001) and after PSM (HR, 0.941; 95% CI: 0.880-1.001).
Our study revealed a significantly increased incidence of HF among participants with hemorrhoids. Therefore, it should be noted that when hemorrhoids are present, the risk of developing HF in the future may be increased.
评估痔疮与心力衰竭（HF）之间关联的研究有限。我们旨在通过一项基于人群的纵向队列研究来评估HF发病率增加与痔疮存在之间的关联。
本研究纳入了356,033名参与者，数据来源于2003年至2007年从韩国健康筛查队列数据库收集的健康筛查数据。根据国际疾病分类第十版（ICD - 10）编码I84，将至少有两项记录的情况确定为患有痔疮。倾向得分匹配（PSM）用于根据痔疮的存在和治疗情况将参与者分为两组。主要结局是HF的发病率，定义为根据ICD - 10编码I50有两项或更多记录。
在参与者中，观察到24,363人（6.8%）患有痔疮。在中位随访期13.33年（四分位间距，10.4 - 16.26）内，共发生55,167例HF累积病例（15.5%）。在多变量分析中，有痔疮组的HF发病率始终高于无痔疮组，在PSM之前[风险比（HR）：1.073；95%置信区间（CI）：1.028 - 1.121]和PSM之后（HR：1.073；95%CI：1.018 - 1.131）均如此。关于痔疮的外科手术/治疗，接受痔疮外科手术或治疗的参与者在PSM之前（HR，0.919；95%CI：0.845 - 1.001）和PSM之后（HR，0.941；95%CI：0.880 - 1.001）的HF发病率较低。
我们的研究显示，患有痔疮的参与者中HF发病率显著增加。因此，应注意当存在痔疮时，未来发生HF的风险可能会增加。
