Study: autoimmune disorders increase cardiovascular risk

Diabetes patient injecting insulin

Individuals with an autoimmune disorder have a substantially higher risk of developing cardiovascular disease, a large epidemiological study has revealed. 

The research – led by KU Leuven in collaboration with colleagues in the UK, including the University of Glasgow, and published in The Lancet – shows for the first time that cardiovascular risks affect autoimmune disorders as a group of diseases, with implications across a broad range of cardiovascular outcomes. 

The excess risk is particularly high among younger patients and suggests that autoimmune disorders are particularly important in causing premature cardiovascular disease, with the potential to result in a disproportionate loss of life years and disability. 

Excess risk comparable to type 2 diabetes

Although earlier research has suggested associations between some of these disorders, particularly type 2 diabetes, and a higher risk of cardiovascular disease, this research shows for the first time that cardiovascular risks affect autoimmune disease as a group of disorders, rather than selected disorders individually.

Nathalie Conrad, lead author of the study from KU Leuven, said: “The results show that action is needed. We see that the excess risk is comparable to that of type 2 diabetes. But although we have specific measures targeted at diabetes patients to lower their risk of developing cardiovascular disease – in terms of prevention and follow-up – we don’t have any similar measures for patients with autoimmune disorders.”

Around 10% of the population in high income regions like Europe and the United States has been diagnosed with one or multiple autoimmune disorders, such as rheumatoid arthritis, psoriasis, systemic sclerosis, lupus erythematosus and type I diabetes.

The results of the study show that these individuals have a substantially higher risk (between 1.4 and 3.6 times depending on which autoimmune condition) of developing cardiovascular disease than people without an autoimmune disorder. 

Targeted prevention measures needed

In The Lancet paper, the authors show that the group of nineteen autoimmune disorders they studied accounts for about 6% of cardiovascular events.

Prof John McMurray, Professor Cardiology at the University of Glasgow’s School of Cardiovascular and Metabolic Heath, said: “This important population-based study suggests that a much broader range of autoimmune disorders than previously recognised are associated with a variety of different cardiovascular problems. 

“Some of these problems are potentially preventable using readily available treatments such as statins. The scale of this enormous new study and the breadth of findings across the full spectrum of autoimmune diseases suggest the contribution of this conditions to the burden or cardiovascular diseases in the community may be considerable and the value of a preventive approach substantial.” 

Prof Conrad added: “We need to develop targeted prevention measures for these patients. And we need to do further research that helps us understand why patients with an autoimmune disorder develop more cardiovascular diseases than others, and how we can prevent this from happening.”

The study was based on electronic health records from the UK’s Clinical Practice Research Datalink (CPRD) and funded by the European Union’s Horizon 2020, European Society of Cardiology, Wellcome Trust, National Institute for Health and Care Research (NIHR), British Heart Foundation, and UKRI’s Global Challenge Research Fund.

‘Autoimmune disorders and cardiovascular risk: A population-based study on 19 autoimmune disorders and 12 cardiovascular diseases in 22 million individuals’ is published in The Lancet.

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