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Heart Health, Explained

Celiac Disease: Chronic Inflamation and Risk of Coronary Artery Disease

Celiac disease is a chronic inflammatory condition that can damage the small intestine, interfering with the absorption of key nutrients. In a study that adds to evidence of the role chronic inflammation may play in heart health, researchers found that people with celiac disease may have nearly double the risk of coronary artery disease compared with the general population. The data for this study, the first to look at this association, were presented at the American College of Cardiology’s 63rd Annual Scientific Session and publicized in Healthline News on March 31, 2014.

Celiac Disease Q&A

Q: People with celiac disease cannot tolerate gluten – a protein found in food such as wheat, rye and barley. How does the consumption of gluten lead to inflammation in people with celiac disease? What does this inflammation do to arteries supplying blood to the heart?

A: For people with celiac disease, the consumption of gluten triggers an immune response in their small intestine. An immune response is how your body defends itself against foreign substances that appear harmful. The body responds by releasing substances such as white blood cells, chemicals such as histamine, and proteins to combat foreign material in a process called inflammation. Although inflammation initially occurs locally (in celiac disease the inflammatory response occurs in the gut), it can travel via the blood to affect other organs such as the heart. In fact, it has long been known that low-level inflammatory conditions such as rheumatoid arthritis, inflammatory bowel disease or lupus erythematosus can accelerate coronary artery disease (CAD) – or the blockage of the arteries that supply blood to your heart.

Q: There are many people who may have gluten sensitivities but do not have celiac disease. Are these people also at risk for coronary artery disease? Are there steps that people with celiac disease and/or gluten sensitivities should take to determine and decrease their heart disease risk?

A: Although this study suggests a link between celiac disease and CAD, it still needs to be determined what steps are appropriate to actually reduce the risk of heart disease in patients with celiac disease. This study also doesn’t address people who have gluten sensitivities without having true celiac disease. For people with gluten sensitivities, further investigation is needed to evaluate their risk of CAD and to determine what future steps may be helpful to protect against heart disease. Even so, it is important for those with gluten sensitivities to be alert to the possible increased risk of CAD if gluten is allowed to trigger inflammatory responses.

Q: How was this association between celiac disease and coronary artery disease found? What kind of data were gathered and analyzed, and what specifically was revealed?

A: Researchers discovered the link between celiac disease and CAD by performing a retrospective study where they reviewed the records of more than 22.4 million patients from 13 healthcare systems over 14 years. They identified 24,530 patients with celiac disease and compared those patients to patients without the disease. After ensuring that the two groups were similar in factors including gender, race, diabetes, high blood pressure, cholesterol levels, and smoking, the researchers found that patients in the celiac group had an almost two-fold increase in the risk of CAD. Interestingly, this association held true for younger patients under the age of 65. Additionally, people with celiac disease had a slightly higher risk for stroke, almost a 1.5-fold increase.

Reference: Celiac Disease Linked to Increased Risk of Coronary Artery Disease, American College of Cardiology press release, March 29, 2014.

HEALTH NEWS IN PERSPECTIVE

Answers to your questions on timely topics in cardiac care to help make sense of research reports in the media. The series includes questions on your heart and the effect of medications, exercise, diet, and hormones.

Team Specialist

Gregory K.W. Lam, MD, FACC, Non-Invasive Cardiology; Peripheral Vascular Disease, OhioHealth Heart & Vascular Physicians

Q&A Editor

Teresa Caulin-Glaser, MD, FACC, FAACVPR System Vice President, Heart & Vascular Services OhioHealth Healthcare System, Columbus, Ohio

Heart Health Explained is a collaboration of Women’s Health Research at Yale and the OhioHealth Healthcare System, a nationally recognized not-for-profit organization with providers across 46 counties, offering a holistic approach to prevention, treatment and rehabilitation of heart disease. OhioHealth is staffed by physicians, psychologists, nutritionists and nurses who answer the questions of the moment on heart and vascular health.

The information provided here may help you make more informed choices. However, it is not a substitute for an individualized medical opinion or diagnosis, and everyone should always consult with their personal physicians to make decisions about their condition or treatment.