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Risk of Adverse Cardiovascular Outcomes in Postmenopausal Women with Inflammatory Bowel Disease
Journal article   Open access   Peer reviewed

Risk of Adverse Cardiovascular Outcomes in Postmenopausal Women with Inflammatory Bowel Disease

Ruby Greywoode, Joseph Larson, Jellyana Peraza, Rachel Clark, Matthew A. Allison, Naueen A. Chaudhry, Peter F. Schnatz, Aladdin H. Shadyab, Robert B. Wallace and Sylvia Wassertheil-Smoller
Digestive diseases and sciences, Vol.69(7), pp.2586-2594
07/2024
DOI: 10.1007/s10620-024-08348-2
PMCID: PMC11258184
PMID: 38684633
url
https://doi.org/10.1007/s10620-024-08348-2View
Published (Version of record) Open Access

Abstract

Background Individuals with inflammatory bowel disease (IBD) who lack traditional cardiovascular disease (CVD) risk factors, such as young females, are observed to experience adverse CVD outcomes. Whether women with IBD have increased CVD risk after the menopause transition is unclear.Methods We conducted a survival analysis of Women's Health Initiative (WHI) participants and excluded those with missing IBD diagnosis, model covariate data, follow-up data, or a baseline history of the following CVD outcomes: coronary heart disease (CHD), ischemic stroke, venous thromboembolism (VTE), peripheral arterial disease (PAD). Risk of outcomes between IBD and non-IBD women was performed using Cox proportional hazard models, stratified by WHI trial and follow-up. Models were adjusted for age, socio-demographics, comorbidities (e.g., hypertension, diabetes, hypercholesterolemia, etc.), family history, and lifestyle factors (e.g., smoking, alcohol, physical activity, body mass index, etc.).Results Of 134,022 WHI participants meeting inclusion criteria, 1367 (1.0%) reported IBD at baseline. Mean baseline age was 63.4 years. After adjusting for age and other confounders, no significant difference was observed between IBD and non-IBD women for the risk of CHD (HR 0.96, 95% CI 0.73-1.24), VTE (HR 1.11, 95% CI 0.81-1.52) or PAD (HR 0.64, 95% CI 0.28-1.42). After adjusting for age, risk of ischemic stroke was significantly higher (HR 1.41, 95% CI 1.06-1.88) in IBD than non-IBD women. With further adjustment, the excess risk of ischemic stroke among IBD women was attenuated and no longer statistically significant (HR 1.31, 95% CI 0.98-1.76).Conclusions Among postmenopausal women with IBD, risk of ischemic stroke may be higher than in non-IBD women.
Gastroenterology & Hepatology Life Sciences & Biomedicine Science & Technology

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