Nav: Home

Connective tissue disease increases risk for cardiovascular problems

February 04, 2016

A study based on medical records from more than a quarter million adult patients found that African-American patients with connective tissue diseases such as lupus or rheumatoid arthritis were twice as likely as white patients to suffer from narrowed or atherosclerotic blood vessels, which increase the risk of a heart attack, stroke or death.

The study, published Feb. 4, 2016, in the open access Nature journal, Scientific Reports, also showed that the prevalence of narrowed blood vessels in patients with connective tissues disease (CTD) was particularly high in young African-Americans.

"These findings raise new questions about the links between inflammation, connective tissue diseases and atherosclerotic cardiovascular disease," said study author Francis Alenghat, MD, PhD, assistant professor of medicine in the section of cardiology at the University of Chicago. "They point to differences in heart disease risk tied to systemic inflammation and modified by race and age."

Prior to this study there was "a dearth of formal understanding on interactions of race with connective tissue diseases in determining cardiovascular risk," Alenghat said. Previous studies focused on less diverse populations. In order to understand these interactions, Alenghat turned to "the large, diverse patient population seen here at the University of Chicago" to provide insights.

Alenghat queried de-identified charts from more than 287,000 African-American and Caucasian patients treated at the University's medical center. He found 10 percent of the African-American patients suffered from atherosclerotic cardiovascular disease--defined as a heart attack, ischemic heart disease, angina, coronary artery disease or atherosclerotic disease of any artery. The prevalence was slightly lower, 8.4 percent, in Caucasians.

When he tallied up patients with connective tissue disease--such as rheumatoid arthritis, lupus, scleroderma or dermatomyositis--there was a clear connection between CTD and increased risk of atherosclerotic cardiovascular disease. The 8,747 patients with some form of CTD were more likely to have cardiovascular disease, especially if they were African-American.

Alenghat found nearly 30 percent of African-Americans with CTD also had cardiovascular disease, three times more than African-Americans without CTD.

White patients with CTD had a much smaller increase. Almost 15 percent of patients had cardiovascular disease, 1.8 times more than white patients without CTD.

African Americans with CTD also developed cardiovascular disease sooner. In the study, more than nine percent of young African-American adults aged 18 to 44 with CTD had received a diagnosis of atherosclerosis. They were 4.7 times more likely to have atherosclerosis than Caucasians of the same age with CTD.

The association of CTD with atherosclerotic cardiovascular disease "was more prominent in African-Americans and in the young," he said.

African-Americans were also more likely than whites to have traditional risk factors for cardiovascular disease, with significantly higher levels of diabetes, smoking and hypertension.

"The molecular and cellular causes of each connective tissue disease are distinct," Alenghat said. "But they all involve systemic inflammation." The data from this study suggest "we should consider lower thresholds for primary prevention in many patients with CTD," he added.

Still, Alenghat, a preventive cardiologist interested in the intersection of inflammation and cardiovascular disease, stressed there are several limitations to this study. It was retrospective. It relied on rigid diagnostic codes for complex multi-faceted diseases as well as simplified classifications of race. And it was designed to detect correlations, rather than determine causal relationships.

Nonetheless, "the findings show that CTD is associated with higher prevalence of atherosclerotic cardiovascular disease, an association that is accentuated in African-Americans and in young adults," Alenghat said. "These insights could be used to improve how we evaluate many patients with a wide range of connective tissue diseases."

They also support the importance of controlling inflammation and identifying and addressing traditional cardiovascular risks factors.

"If we were to view the current findings on the backdrop of contemporary cardiovascular risk calculators and statin guidelines, many patients with connective tissue disease could reasonably consider moderate-intensity statin therapy at age 35," he said.
The National Heart, Lung, and Blood Institute and the University of Chicago's Center for Research Informatics and the Institute for Translational Medicine funded this study.

University of Chicago Medical Center

Related Heart Attack Articles:

Where you live could determine risk of heart attack, stroke or dying of heart disease
People living in parts of Ontario with better access to preventive health care had lower rates of cardiac events compared to residents of regions with less access, found a new study published in CMAJ (Canadian Medical Association Journal).
Activated T-cells drive post-heart attack heart failure
Chronic inflammation after a heart attack can promote heart failure and death.
ICU care for COPD, heart failure and heart attack may not be better
Does a stay in the intensive care unit give patients a better chance of surviving a chronic obstructive pulmonary disease (COPD) or heart failure flare-up or even a heart attack, compared with care in another type of hospital unit?
Heart attack treatment might be in your face
Researchers at the University of Cincinnati have received $2.4 million in federal funding to pursue research on a novel cell therapy that would repair heart damage using modified cells taken from the patient's own facial muscle.
Tissue engineering advance reduces heart failure in model of heart attack
Researchers have grown heart tissue by seeding a mix of human cells onto a 1-micron-resolution scaffold made with a 3-D printer.
Study shows functional effects of human stem cell delivery to heart muscle after heart attack
Researchers delivered human stem cells seeded in biological sutures to the damaged heart muscles of rats following induced acute myocardial infarction and assessed the effects on cardiac function one week later.
Younger heart attack survivors may face premature heart disease death
For patients age 50 and younger, the risk of premature death after a heart attack has dropped significantly, but their risk is still almost twice as high when compared to the general population, largely due to heart disease and other smoking-related diseases The risk of heart attack can be greatly reduced by quitting smoking, exercising and following a healthy diet.
After the heart attack: Injectable gels could prevent future heart failure (video)
During a heart attack, clots or narrowed arteries block blood flow, harming or killing cells in the heart.
Heart failure after first heart attack may increase cancer risk
People who develop heart failure after their first heart attack have a greater risk of developing cancer when compared to first-time heart attack survivors without heart failure, according to a study today in the Journal of the American College of Cardiology.
1 in 4 patients develop heart failure within 4 years of first heart attack
One in four patients develop heart failure within four years of a first heart attack, according to a study in nearly 25,000 patients presented today at Heart Failure 2016 and the 3rd World Congress on Acute Heart Failure by Dr.

Related Heart Attack Reading:

Beat the Heart Attack Gene: The Revolutionary Plan to Prevent Heart Disease, Stroke, and Diabetes
by Bradley Bale M.D. (Author), Amy Doneen ARNP (Author), Lisa Collier Cool (Contributor), Larry King (Contributor)

A revolutionary, personalized guide to preventing heart disease based on genetic factors

Heart disease is the #1 cause of death in America. It affects 81 million Americans and is the culprit in one of every two deaths in the United States. Most people think that they are not at risk of a heart attack if they control their cholesterol and blood pressure, but they aren’t aware of other major risk factors. The good news is that with the right information and strategies, heart attacks are preventable—even if heart disease runs in the family.

In Beat the Heart... View Details

Fat and Cholesterol Don't Cause Heart Attacks and Statins are Not The Solution
by Paul J. Rosch MD (Author), Zoë Harcombe PhD (Author), Malcolm Kendrick MD (Author), Uffe Ravnskov MD PhD (Author), Fred A. Kummerow PhD (Author), Harumi Okuyama PhD (Author), Peter H. Langsjoen MD (Author), Alena M. Langsjoen MS (Author), Naoki Ohara PhD (Author), David M. Diamond PhD (Author), Tomohito Hamazaki MD PhD (Author), Stephanie Seneff PhD (Author), Carlos Monteiro (Author), Kilmer S. McCully MD (Author), Luca Mascitelli MD (Author), Mark R. Goldstein MD (Author), Michel de Lorgeril MD (Author), Mikael Rabaeus MD (Author), Duane Graveline MD MPH (Author), Sherif Sultan MD Phd (Author), Edel P. Kavanagh PhD (Author)

This book is dedicated to Uffe Ravnskov, MD, Ph.D. for his seminal and propaedeutic achievements in disputing the dogma that fat and cholesterol cause coronary heart disease, and that statins are safe and cardioprotective for everyone. As will be seen, no studies support the notion that restricting fat reduces coronary morbidity or mortality. More importantly, government recommendations mandating low fat diets are likely the cause of the escalating epidemic of obesity and type 2 diabetes. Several chapters detail the panoply of significant adverse health effects of statins that have been... View Details

Prevent a Second Heart Attack: 8 Foods, 8 Weeks to Reverse Heart Disease
by Janet Bond Brill Ph.D. R.D. (Author), Annabelle S. Volgman M.D. (Foreword)

Reverse Your Heart Disease in Just Eight Weeks by Harnessing the Power of the Mediterranean Diet

If you’re one of the 13 million Americans who have survived a heart attack or been diagnosed with heart disease, Dr. Janet Bond Brill offers a delicious and foolproof plan that can lower your risk of a second heart attack by up to 70 percent.  Inspired by the heart-healthy Mediterranean diet, the Prevent a Second Heart Attack Plan is based on satisfaction, rather than deprivation.   

Backed by cutting edge research, Dr. Brill explains:

   • Why the... View Details

Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure
by Caldwell B. Esselstyn Jr. (Author)

The New York Times bestselling guide to the lifesaving diet that can both prevent and help reverse the effects of heart disease

Based on the groundbreaking results of his twenty-year nutritional study, Prevent and Reverse Heart Disease by Dr. Caldwell Esselstyn  illustrates that a plant-based, oil-free diet can not only prevent the progression of heart disease but can also reverse its effects.  Dr. Esselstyn is an internationally known surgeon, researcher and former clinician at the Cleveland Clinic and a featured expert in the acclaimed documentary Forks... View Details

The Cardiac Recovery Handbook: The Complete Guide to Life After Heart Attack or Heart Surgery, Second Edition
by Paul Kligfield M.D. (Author), Michelle D. Seaton (Author), Frederic Flach MD KCHS (Afterword)

How long will I be in the hospital? Do I need to give up all my favorite foods? What are the side effects of that medication? Why do I feel so depressed? When can I have sex again? How can I prevent a second heart attack?

Heart surgery or heart attack can be the most frightening experience of your life. Dr. Paul Kligfield, MD, one of the nation's most respected cardiologists, answers all your questions and many more in The Cardiac Recovery Handbook: The Complete Guide to Life After Heart Attack or Heart Surgery. In clear, everyday language, Dr. Kligfield provides a... View Details

Heart Attack Proof: A Six-Week Cardiac Makeover for a Lifetime of Optimal Health
by Michael Ozner (Author)

A combination of the newest blood tests, medications, and nutrition approaches have made coronary heart disease preventable, but for most of us, it’s still not a question of if, but when. Renowned and leading preventive cardiologist Michael Ozner says there’s no reason to wait until you have a heart attack or stroke.

In Heart Attack Proof, Dr. Ozner shares the same six-week cardiac makeover to prevent and reverse heart disease he has been successfully giving his patients for more than 25 years. Even if you’ve been diagnosed with heart disease or have... View Details

Too Young for a Heart Attack
by Stu Segal (Author), Stephen H. Segal (Consultant Editor), Dr. Ian J. Molk M.D. (Consultant Editor)

Stu Segal was a fit, healthy 37-year-old--or that's what he thought until Fathers' Day 1987 ended with a heart attack. When the ER doctor told him he might or might not survive, he realized that, one way or another, life as he knew it was over.

Stu traces the journey of a man facing the new reality that though much of what he loved was gone, yes, he might still be able to live a long and happy life--if he methodically changed his approach to the things he'd always taken for granted. Over the course of weeks, months and years, Stu says goodbye to the habits he's used to and rebuilds... View Details

The Cardiac Recovery Cookbook: Heart Healthy Recipes for Life After Heart Attack or Heart Surgery
by M. Laurel Cutlip LN RD (Author), Sari Greaves RDN (Author), Paul Kligfield M.D. (Foreword)

Help Your Heart by Eating Right!

If you are looking to eat healthier and still enjoy mealtime, open your kitchen to The Cardiac Recovery Cookbook. This indispensable companion to The Cardiac Recovery Handbook contains over 100 quick, easy, and delicious NIH-approved recipes to help cardiac patients eat well on the road to wellness.

Whether you want a quick meal, a nutritious dinner, or a heart-healthy dessert, this book is packed with great tasting recipes the whole family can enjoy.

All the recipes are reduced in saturated fat, cholesterol, and... View Details

Before the Heart Attacks: A Revolutionary Approach to Detecting, Preventing, and EvenReversing Heart Dise
by Robert Superko (Author)

A California cardiologist stresses that one size does not fit all patients in terms of prevention. Dr. Superko offers individualized risk assessment, diet, exercise, medication, and supplement plans. Annotation ©2004 Book News, Inc., Portland, OR ( View Details

Heart Attack Anatomy Coloring Book
by Wynn J. Elson (Author)

Why choose this Heart attack anatomy coloring book? This book is made neatly combining anatomy and art together! This is what you are looking for. From a biological point of view, the human body is an infinitely complex marvel of fine design, superbly adapted to its functions by eons of evolutionary development. Hundreds of specialized organs, bones, muscles, nerve fibers, blood vessels, and other anatomical features comprise an interdependent network of bodily systems that enables the human organism to survive. Now the component parts of this intricate flesh-and-bone machine can be absorbed... View Details

Best Science Podcasts 2018

We have hand picked the best science podcasts for 2018. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

The Consequences Of Racism
What does it mean to be judged before you walk through the door? What are the consequences? This week, TED speakers delve into the ways racism impacts our lives, from education, to health, to safety. Guests include poet and writer Clint Smith, writer and activist Miriam Zoila Pérez, educator Dena Simmons, and former prosecutor Adam Foss.
Now Playing: Science for the People

#465 How The Nose Knows
We've all got a nose but how does it work? Why do we like some smells and not others, and why can we all agree that some smells are good and some smells are bad, while others are dependant on personal or cultural preferences? We speak with Asifa Majid, Professor of Language, Communication and Cultural Cognition at Radboud University, about the intersection of culture, language, and smell. And we level up on our olfactory neuroscience with University of Pennsylvania Professor Jay Gottfried.