Autoimmune Disease Augments Cardiovascular Risk Save

A large UK database study suggests that young adults with autoimmune diseases have an associated increased risk for cardiovascular disease.

A population-based study examined 22,009,375 persons from the Clinical Practice Research Datalink (CPRD), GOLD and Aurum datasets.  This included a subset with newly diagnosed, 19 autoimmune diseases (n=446 449) and over 2.1 million matched controls seen between 2000 and 2017. They included those under age 80 years without a cardiovascular disease in the prior 12 months.

Autoimmune cohort were 61% were women.  After a median of 6.2 years followup, cardiovascular disease was more likely in the autoimmune patients (15·3%) that those without AID (11%). This translates to a CVD incidence rate of 23.3 events per 1000 patient-years (compared to 15 events per 1000 patient-years) with a higher risk among those with an autoimmune disease (hazard ratio 1.56; CI 1·52–1·59).

CV disease risk was increased moreso in younger age groups (age <45 years: HR 2·33) compared to ages 55–64 years (HR 1·76) and ≥75 years (HR 1·30). CV risk mounted with increasing numbers of autoimmune disease (one disease: HR 1·41; two diseases: HR 2·63; three or more HR 3·79 [3·36–4·27].

CV risk was highest with systemic sclerosis (HR 3·59), Addison's disease (HR 2·83), systemic lupus erythematosus (HR 2·82), and type 1 diabetes (HR 2·36).

Screening and cardiovascular prevention measures should be strongly considered in those with autoimmune diseases, especially before age 45 years.

Funding