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Inflammatory bowel disease may increase risk of heart failure
Last reviewed: 02.07.2025
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Inflammatory bowel disease (IBD) is associated with a small increased risk of heart failure for up to 20 years after diagnosis, according to a comprehensive study led by the Karolinska Institutet in Sweden and published in the European Heart Journal.
Researchers analyzed the risk of heart failure in more than 80,000 patients with inflammatory bowel disease — Crohn's disease, ulcerative colitis, or unspecified IBD — compared with 400,000 people in the general population as part of the ESPRESSO study.
The results show that people with IBD have a 19% increased risk of developing heart failure within 20 years of diagnosis. This corresponds to one additional case of heart failure per 130 patients with IBD over those 20 years, and the increased risk was observed regardless of the type of IBD. The greatest risk of heart failure was seen in older patients, people with lower levels of education, and people with pre-existing cardiovascular disease at the time of IBD diagnosis.
"Both healthcare professionals and patients need to be aware of this increased risk, and it is important that cardiovascular health is closely monitored," says first author of the study Jiangwei Song, a researcher in the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet. "We hope that the results will increase awareness among healthcare professionals of the increased risk of heart failure in individuals with IBD and contribute to the creation of new guidelines for the management of cardiovascular disease in patients with IBD."
The researchers also analyzed the risk of heart failure in patients with IBD compared with their siblings without IBD. In these analyses, the risk increased by 10%, suggesting that genetic and early environmental factors shared by family members may play a role.
"We don't know if there is a causal relationship, but we will continue to investigate genetic factors and the role of IBD medications and disease activity in increasing the risk of heart failure," says senior study author Professor Jonas F. Ludvigsson from the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet.
The study was conducted in collaboration with researchers from Örebro University, the University of Gothenburg and Uppsala University in Sweden.