Is Gallstone Disease Associated With CHD?

A history of gallstone disease is associated with future coronary heart disease (CHD) risk, according to a new study.

“Several previous studies have related a history of gallstone disease to cardiovascular risk,” the researchers said. “However, some studies had short-term follow-up, did not confirm gallstone cases, or did not account for important covariates such as lifestyle and dietary habits. Notably, most of the previous studies were not conducted in the US population; and data from the US cohorts are lacking.”

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The investigators followed up on 269,142 participants free of cancer and cardiovascular disease at baseline from 3 US cohorts: the Nurses’ Health Study (112,520 women; 1980-2010), Nurses’ Health Study II (112,919 women; 1989-2011), and the Health Professionals Follow-Up Study (43,703 men; 1986-2010) and documented 21,265 incident CHD cases. After adjustment for potential confounders, the hazard ratio for the participants with a history of gallstone disease compared with those without was 1.15 (95% confidence interval [CI], 1.10-1.21) in the Nurses’ Health Study, 1.33 (95% CI, 1.17-1.51) in the Nurses’ Health Study II, and 1.11 (95% CI, 1.04-1.20) in the Health Professionals Follow-Up Study. The associations seemed to be stronger in individuals who were not obese, were not diabetic, or were normotensive, compared with their counterparts.

The researchers identified 4 published prospective studies by searching PubMed and EMBASE up to October 2015, coupled with their 3 cohorts, involving 842,553 participants and 51,123 incident CHD cases. The results from meta-analysis showed a history of gallstone disease to be associated with a 23% (15%-33%) increased CHD risk.

“Although this study may not be able to prove a causal relationship between gallstone disease and CHD, the long-term implications of gallstone disease on heart health are important in clinical practice,” the investigators said.

They plan to analyze whether gallstones affect other health outcomes, such as diabetes and mortality, said study author Lu Qi, MD, PhD, professor of epidemiology at Tulane University in New Orleans.

—Mike Bederka

Reference:

Zheng Y, Xu M, Li Y, et al. Gallstones and risk of coronary heart disease: prospective analysis of 270000 men and women from 3 US cohorts and meta-analysis [published online August 18, 2016]. Arterioscler Thromb Vasc Biol. doi:10.1161/ATVBAHA.116.307507.