title: Increased risk for coronary heart disease, asthma, and connective tissue diseases in inflammatory bowel disease.
abstract: OBJECTIVE
  Patients with inflammatory bowel diseases (IBD) show increased risk for other immune-mediated diseases such as arthritis, ankylosing spondylitis, and some pulmonary diseases. Less is known about the prevalence of other chronic diseases in IBD, and the impact of comorbidity on health-related quality of life (HRQoL).
  
  
  METHODS
  The study population comprised 2831 IBD patients recruited from the National Health Insurance register and from a patient-association register. Study subjects completed generic 15D and disease-specific IBDQ questionnaires. The Social Insurance Institution of Finland provided data on other chronic diseases entitling patients to reimbursed medication. For each study subject, two controls, matched for age, sex, and hospital district, were chosen.
  
  
  RESULTS
  A significant increase existed in prevalence of connective tissue diseases, pernicious anemia and asthma. Furthermore, coronary heart disease (CHD) occurred significantly more frequently in IBD patients than in their peers (p=0.004). The difference was, however, more clearly seen in females (p=0.014 versus 0.046 in males). Active and long-lasting IBD were risk factors. Concomitant other chronic diseases appeared to impair HRQoL. Asthma, hypertension and psychological disorders had an especially strong negative impact on HRQoL, as observed with both the generic and disease-specific HRQoL tools.
  
  
  CONCLUSIONS
  In addition to many immune-mediated diseases, CHD appeared to be more common in IBD than in control patients, especially in females. The reason is unknown, but chronic inflammation may predispose to atherosclerosis. This finding should encourage more efficacious management of underlying cardiovascular risk factors, and probably also inflammatory activity in IBD.
authors.affiliation: Department of Medicine, Division of Gastroenterology, Helsinki University Central Hospital, Helsinki, Finland. johanna.haapamaki@hus.fi
authors.forename: Johanna
authors.initials: J
authors.lastname: Haapamäki
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.forename: Ulla
authors.initials: U
authors.lastname: Turunen
authors.forename: Martti A
authors.initials: MA
authors.lastname: Färkkilä
authors.forename: Perttu E T
authors.initials: PE
authors.lastname: Arkkila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000752:Anemia, Pernicious / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology*; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000453:epidemiology; D015897:Comorbidity; D003240:Connective Tissue Diseases / Q000453:epidemiology*; D003327:Coronary Disease / Q000453:epidemiology*; D003424:Crohn Disease / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult