Inflammation has been shown to play an increasingly important role in the pathogenesis of atherosclerosis and in precipitating thrombotic events. Inflammatory bowel disease (IBD) is a systemic inflammatory disorder with a wide range of extraintestinal manifestations including a clinically significant increase in the risk of venous thromboembolism compared to matched controls in several studies. The data for the association between IBD and ischemic heart disease are less clear; multiple population-based studies have shown both positive and negative associations between the 2 conditions. While the systemic inflammation should theoretically increase the risk for cardiovascular disease, inflammatory bowel also potentially provides a cardioprotective effect in several ways. Patients with IBD typically enter the healthcare system at an earlier age and experience a lower incidence of obesity, hypercholesterolemia, and hyperlipidemia. Given the complex interplay among the proatherogenic, prothrombogenic, and cardioprotective effects, IBD should be taken into consideration as a nontraditional risk factor for cardiovascular disease in specific subsets of patients.
From the *Department of Internal Medicine, University of Virginia, Charlottesville, VA
†Department of Internal Medicine, Loyola University Medical Center, Maywood, IL
‡Division of Gastroenterology, Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY
§Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.
Disclosure: The authors declare no conflict of interest.
Correspondence: William H. Frishman, MD, Department of Medicine, New York Medical College, 40 Sunshine Cottage Road Valhalla, NY 10595. E-mail: William_Frishman@nymc.edu.