Can autoimmune disease cause heart problems?

A few months ago, I attended a funeral of a friend from my past. Shockingly, she passed away suddenly from a heart attack. Everyone who knew her was in a state of shock. In their disbelief, I heard things like, “I don’t understand. She always took care of herself.” “This is the last person I thought would have a heart attack.” My friend had no pre-existing conditions, exercised regularly, and was an avid golfer. She was considered healthy.

This unfortunate situation made me think about my heart health and pre-existing condition. I wondered, can autoimmune disease cause heart problems or increase your risk of heart problems?

A quick internet search will result in health conditions that are risk factors and increase the probability of heart disease. According to the CDC, these include:

• High blood pressure. It’s often called “the silent killer” because it has no symptoms. Check your blood pressure.
• High cholesterol levels. Unhealthy diets can lead to high blood cholesterol levels, which causes plaque in arteries and decreases blood flow to the heart. A blood test can determine if a person’s cholesterol level is high enough to put them at risk for heart problems.
• Diabetes. High blood sugar levels are linked to a higher risk of heart disease.
• Obesity. Being seriously overweight is tied to other health problems, including diabetes, high cholesterol, and high blood pressure.

Yes, we all know about those, but what about autoimmune diseases? After some more digging, I came across a worrisome research article:

“We found that, among 19 of the most common autoimmune disorders, all conditions were associated with increased cardiovascular risk, indicating a pattern that affects autoimmune disorders as a group of diseases rather than individually.”

Nathalie Conrad, Geert Verbeke, Geert Molenberghs, Laura Goetschalckx, Thomas Callender, Geraldine Cambridge, Justin C Mason, Kazem Rahimi, John J V McMurray, Jan Y Verbakel – Published, August 27, 2022

Research Findings

The research study quoted above is titled “Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK.” Yes, a long title!

The study included individual data records from 2000 to 2019. The autoimmune cohort included patients with an incident autoimmune disease, less than 80 years old at diagnosis, and free of cardiovascular disease until 12 months after the autoimmune disease diagnosis.

Autoimmune diseases included

The study included individuals with these 19 autoimmune diseases:

1. Addison’s disease
2. Ankylosing spondylitis
3. Coeliac disease
4. Type 1 diabetes
5. Graves’ disease
6. Hashimoto’s thyroiditis
7. Inflammatory bowel disease (including Crohn’s disease and ulcerative colitis)
8. Multiple sclerosis
9. Myasthenia gravis
10. Pernicious anemia
11. Polymyalgia rheumatica
12. Primary biliary cirrhosis
13. Psoriasis
14. Rheumatoid arthritis
15. Sjögren’s syndrome
16. Systemic lupus erythematosus
17. Systemic sclerosis
18. Vasculitis (including temporal arteritis, giant cell arteritis, polyarteritis nodosa, and antineutrophilic cytoplasmic antibody-positive vasculitis)
19. Vitiligo

Diseases were considered individually and as a composite outcome of all autoimmune diseases combined and in subgroups of connective tissue and organ-specific diseases. For the analyses, each individual’s first recorded autoimmune disease was used.

Cardiovascular diseases included

To best characterize the broad spectrum of cardiovascular disease, the study examined the following 12 conditions:

1. Aortic aneurysm
2. Atrial fibrillation and flutter
3. Supraventricular arrhythmias
4. Conduction system disease
5. Heart failure
6. Ischemic heart disease
7. Myocarditis and pericarditis (of non-infectious origin)
8. Peripheral arterial disease
9. Infective endocarditis
10. Stroke (ischemic and hemorrhagic) or transient ischemic attack
11. Valve disorders (excluding congenital and rheumatic)
12. Venous thromboembolism or pulmonary embolism

The study included other traditional cardiovascular risk factors, such as age, sex, socioeconomic status, blood pressure, BMI, smoking, type 2 diabetes, or cholesterol, but, unfortunately, too much to cover in this post. Please refer to the original link to review the research paper.

Conclusions – can autoimmune disease cause heart problems

The findings of this significant population-based study support evidence from previous studies showing that patients with autoimmune disorders have a higher risk of incident cardiovascular disease than those without an autoimmune disease.

Among these 19 most common autoimmune diseases, all were associated with increased cardiovascular risk. This indicates that autoimmunity per se, rather than any individual condition, is the risk factor and that the potential contribution of these diseases to cardiovascular disease in the population is far more significant than previously recognized.

Notably, the observed excess cardiovascular risk with autoimmune disease was not explained by traditional cardiovascular risk factors, such as age, sex, socioeconomic status, blood pressure, BMI, smoking, type 2 diabetes, or cholesterol.

Quick facts from the study

• Those who developed cardiovascular disease did so at a significantly younger age than compared to those without an autoimmune disease.
• People with an autoimmune disease had a considerably higher risk of developing cardiovascular disease before the age of 65 years.
• Patients with two or more autoimmune conditions risk of cardiovascular disease increase with the number of autoimmune diseases
• Among autoimmune diseases, the highest cardiovascular risk was seen in Systemic sclerosis, Addison’s disease, Systemic lupus erythematosus, and type 1 Diabetes.

So Can autoimmune disease cause heart problems? The answer is YES.

Create awareness of this association

As cited in the paper, there is little awareness of this association; thus, most patients with autoimmune disease do not receive cardiovascular prevention measures that could help reduce this burden or undergo screening to detect cardiovascular disease. 

We can help raise awareness of the association between autoimmune disease and heart health. Here are ways to raise awareness:

• Tell all of your physicians about this study and the higher risk factors.
• If not already, ask for a referral to a cardiologist to establish a baseline from testing.
• Inform your cardiologist of this study and your autoimmune disease.
• Tell your family and friends about this risk.
• Spread the word through support groups and social media.
• Inform other autoimmune disease warriors of this risk.

Heart healthy choices – keep your heart healthy and strong

Do your part for your health to keep your heart healthy and strong. Reduce the risk of cardiovascular disease by:

• Exercise regularly. Try to get in a minimum of 30 minutes of aerobic exercise, such as walking, cycling, or swimming, at least five days a week.
• Strength training. Do moderate weightlifting or resistance training to tone muscles and build muscle endurance twice a week or frequently enough to cover the major muscle groups.
• Stretch daily. Stretching may reduce the risk of heart attack and stroke by improving blood flow, which may decrease stiffness and damage to the walls of your arteries.
• Find calm intentionally. Allow your brain to quiet down and shut out the world for a portion of your day through activities such as Tai Chi, working on a hobby, baking bread, walking in nature, gardening, knitting, or crafting.
• Eating well
• Managing weight
• Avoiding smoking or vaping
• Learning the warning signs of a heart attack or stroke

Advocate for yourself and others with autoimmune disease. Be sure to inform your doctors, see a cardiologist and spread awareness about the associated risk between autoimmune disease and heart disease. Please see my other posts about exercise, stress management, and healthy eating.