People who have celiac disease may face higher odds of developing cardiovascular disease — even though they often lack the “traditional” risk factors for heart disease such as hypertension, high body mass index, and high cholesterol, according to a study in BMJ Medicine.
Although mixed, some research has linked celiac disease with higher rates of cardiovascular disease. For this study, researchers wanted to know if the increased risk of heart disease (including ischemic heart disease, heart attack, and stroke) among celiac patients stemmed from common cardiovascular disease markers (e.g., high blood pressure or cholesterol). This potential association was not studied in earlier trials.
Scientists pulled data from the UK Biobank, an extensive biomedical database that features half a million people aged 40–60 from England, Scotland, and Wales. They then selected 2083 subjects with celiac disease between 2006 and 2010. At the time, none of the participants had heart disease.
For a little over 12 years, researchers tracked their health via hospital records and death certificates. At the end of the study, after ruling out other contributing factors, scientists discovered that celiac patients had a 27 percent heightened risk of cardiovascular disease when compared to non-celiac patients. The risk further increased based on time spent living with the disease — for example, subjects with celiac disease for less than 10 years had a 30 percent increased chance of cardiovascular diseases versus a 34 percent higher risk in those with the disease for 10 or more years.
Researchers were surprised to find that celiac patients suffered fewer traditional heart disease risk factors — including obesity, high systolic blood pressure, smoking history, and high cholesterol. It is important to note that this is an observational study, meaning it cannot prove cause and effect.
The effects of a gluten-free diet on cardiovascular disease risk were not studied. Several autoimmune conditions come with an increased risk of heart disease, often caused by systemic inflammation, say the study authors. Therefore, more research is needed to investigate the potential anti-inflammatory effects of a gluten-free diet.
“Numerous autoimmune diseases have been found to be associated with an increased risk of cardiovascular disease. One hypothesis for the increased risk is that increased systemic inflammation associated with coeliac [celiac] disease could subsequently increase the risk of cardiovascular disease. In our study, the results remained similar when adjusting for C reac- tive protein, a marker of systemic inflammation. C reactive protein might be a poor marker for inflamma- tion in patients with coeliac disease, as found in other auto-immune diseases, although small case control studies have identified an increased C reactive protein in patients with coeliac disease,” wrote the study authors.
About Celiac Disease
Celiac disease is an autoimmune condition that involves an abnormal reaction/overreaction to gluten, a protein in wheat and certain other grains. According to the Celiac Disease Foundation, 3 million Americans have celiac disease, and 1 in 100 people worldwide suffer from it. Estimates show that 60–70 percent of celiac disease cases in the U.S. go undiagnosed, causing needless suffering. This chronic condition can affect every organ in the body. Following a strict gluten-free diet is the only cure.
“This study highlights the importance of cardiovascular disease as a potential complication of coeliac disease. Further research into the drivers and mechanistic pathways of this association is warranted. In addition, an investigation is warranted into the extent to which any risk reduction is reported by adherence to a gluten-free diet in people with coeliac disease, or whether a gluten-free diet itself contributes to the increased risk identified. Furthermore, consideration should be given to inclusion of coeliac disease as a risk factor in cardiovascular disease risk prediction models, such as the QRISK model, which currently includes other autoimmune conditions (systemic lupus erythematosus and rheumatoid arthritis) as risk factors. Given the increased rates of cardiovascular disease reported in people with coeliac disease who have an ideal and moderate cardiovascular disease risk score, clinicians should make patients with coeliac disease aware of their elevated risk, and work with their patients to optimize their cardiovascular health,” write the study team.