We have known for some time that various autoimmune conditions increase the risk of heart disease, but no big picture of the connection has ever been attempted. These cardiovascular risk factors have always taken a backset to the traditional risks of diabetes, hypertension, and high cholesterol. This research paper sought to bring the big picture into better focus by looking at the overall connection between all autoimmune disease and all cardiovascular events. They concluded that the presence of any autoimmune condition puts the patient at about the average risk of someone with type 2 diabetes, a known major risk factor.
Autoimmune diseases come in a variety of sizes and shapes, but all share the commonality that our immune systems are attacking some part of us, causing damage in some tissue or some organ. For years, some specific autoimmune conditions like lupus were known to increase the risk of heart disease. Rheumatologists caring for these lupus patients would both warn their patients of the risks and work to lower those risks by controlling the inflammation of the disease and addressing regular cardiovascular risk factors like sugar, cholesterol, and blood pressure. They recognized some type of link between the inflammation of autoimmunity and the disease but did not go much further.
By looking at the electronic health records from the United Kingdom’s Clinical Practice Research Datalink (CPRD), which included about 22 million records, they compared the records of those newly diagnosed with one or more of 19 autoimmune diseases in consideration with controls. They looked at these individuals over the following years to see which determined one of 12 different cardiovascular diseases. This went beyond the basic heart disease to include conditions like strokes, valve disease, and other cardiovascular conditions. The patients with autoimmune disease demonstrated a 1.56 times higher risk of some cardiovascular outcome.
Besides this association, they reported other findings. They noted that as a single patient developed more than 1 autoimmune condition, their risk of cardiovascular outcome also rose. They reported that some diseases had the highest risks. These included lupus, type 1 diabetes, Addison’s disease, and systemic sclerosis.
The study was not intended to uncover the mechanisms by which these risks occurred but did offer ideas. Some connection with inflammation and its effects on cardiovascular structures was the obvious primary suspect. They also questioned if some of the therapies for autoimmune conditions might be playing a role in some cases. They urged more investigation and study in these areas so proper prevention and therapy could be employed.
With all this in mind, functional medicine providers focus a lot of attention not just on the root causes of autoimmune conditions but also on the inflammatory cascade which mediates many negative effects besides the cardiovascular ones noted in this study. While we work to remove triggers which set off the autoimmune process in the first place, we want to put out fires as fast as possible to limit the damage. Helping patients restore and maintain healthier more abundant lives requires both of these short-term and long-term therapy goals.
Original Article:
Nathalie Conrad, Geert Verbeke, Geert Molenberghs, Laura Goetschalckx, Thomas Callender, Geraldine Cambridge, Justin C Mason, Kazem Rahimi, John J V McMurray, Jan Y Verbakel. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK. The Lancet, 2022; DOI: 10.1016/S0140-6736(22)01349-6
Thanks to Science Daily:
KU Leuven. “Autoimmune disorders increase risk of cardiovascular disease.” ScienceDaily. ScienceDaily, 28 August 2022. <www.sciencedaily.com/releases/2022/08/220828150105.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.