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  • Jefferson Adams
    Jefferson Adams

    Celiac Disease Doubles Risk of Coronary Artery Disease

    Reviewed and edited by a celiac disease expert.
    Celiac Disease Doubles Risk of Coronary Artery Disease - Image: Wikimedia Commons--Van Brussel
    Caption: Image: Wikimedia Commons--Van Brussel

    Celiac.com 05/05/2014 - People with celiac disease face double the risk of coronary artery disease compared with the general population, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.

    Image: Wikimedia Commons--Van BrusselThe data for the study were gathered by researchers using electronic health records of patients from 13 participating health care systems between January 1999 and September 2013. Out of a total of nearly 22.4 million patients, they found 24,530 with celiac disease. Patients without celiac disease served as controls.



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    The researchers found was no difference in smoking status or diabetes rates between the two groups. Those with celiac disease had slightly higher cholesterol levels, but lower rates of high blood pressure.

    All patients were adults. For both groups, the team found comparable rates of traditional risk factors for coronary artery disease including sex, race, diabetes, high cholesterol, high blood pressure and smoking.

    Overall, the researchers found a significantly higher rates of coronary artery disease among patients with celiac disease compared to the control population. The rates were 9.5 percent for patients with celiac disease, compared to 5.6 percent, of the general population.

    Data showed a similar trend among younger patients, those under age 65, with with 4.5 percent of patients with celiac disease compared to 2.4 percent for those without celiac disease.

    People with celiac disease have some persistent low-grade inflammation in the gut that can spill immune mediators into the bloodstream, which can then accelerate the process of atherosclerosis and, in turn, coronary artery disease," said R.D. Gajulapalli, M.D., clinical associate at the Cleveland Clinic and co-investigator of the study.

    These findings “reinforce the idea that chronic inflammation, whether it's from an infection or a disease, can have an adverse role in coronary artery disease and general heart health, even in the absence of traditional cardiovascular risk factors," Gajulapalli said.

    The team was surprised by the “strength of the association, especially in younger people,” and, in addition to further study, they are calling for patients and doctors to be aware of this association.

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    It would have been helpful if the study indicated whether the patients with celiac disease were following a gluten-free diet.

    Since it was a study generated from electronic health records, without patient interviews, the study could not have included that variable. Still, an interesting study.

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    I would like to add that, although there is no information about compliance with a gluten free diet, what is very likely is that the celiacs eat a good deal of products labelled 'gluten free', and I know that it is actually not possible for any cereal grain to be truly free of glutens, as these are essential part of all grains. There is no doubt at all that corn/maize, rice, sorghum and millet have glutens in. So, if there is still a higher rate of cardiac ill health in celiacs it is probably that they are still eating cereal grains and therefore glutens, just not the glutens that cause reactions in their guts, but in other organs or tissues, such as the heart and blood vessels. I recommend a diet free from all cereal grains, rice, maize, millet, sorghum included, AND buckwheat, quinoa, amaranth and the potato starch as these either have similar proteins in their grains (e.g. buckwheat does) or are just a high starch product, which will engender a low grade chronic inflammation anyway as starch IS glucose and a diet high in glucose (which is the breakdown product of all carbohydrates) will naturally increase inflammation. So I recommend avoiding all those foods with glutens and other immune system triggers (like lectins, dreadful things!) which includes all beans/legumes, all grains or grain-like substances, and keeping inflammatory industrial seed oils out (e.g. sunflower oil, soya oil, corn oil etc) and instead eating the diet we actually evolved on, which is meat, fish, offal, eggs, leafy vege and fresh fruits (by which I mean edible berries, as they are low in sugars but high in nutrients). And I like to encourage the use of dairy products as long as they are the high fat ones, like clarified butter (ghee), and fermented dairy, i.e. cheeses and yogurts and kefir. These are incredibly useful, and, as long as you don't have an allergic reaction to them, are very very health promoting. Enjoy real food again and steer clear of all manufactured stuff.

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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    Celiac.com 12/11/2006 – A retrospective cohort study presented by Gunnar Midhagen with his Doctoral and Licentiate Theses at Linköping University, Sweden, found that those with diagnosed celiac disease actually have a 47% lower cancer risk than the normal population, presumably because a majority of them follow a gluten-free diet (although the study did not address this). The study also found that those with celiac disease have a 38% higher mortality rate than the normal population, which is due to a 48% higher rate of death due to ischemic heart disease. It would be interesting to determine what causes the higher heart disease risk, and I would speculate that it has to do with fat absorption—specifically the decreased ability of those with celiac disease to absorb omega-3 fatty acids. More on this topic can be found in this article:
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    High Mortality in Ischemic Heart Disease in Patients with Celiac Disease
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    Jefferson Adams
    Celiac.com 10/05/2011 - Researchers have established a number of inflammatory markers as risk factors for atrial fibrillation (AF), but they know very little about how autoimmune diseases affect AF.
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    They are affiliated variously with Arvika Hospital in Arvika, Sweden, the Department of Cardiology at Lund University in Lund, Sweden, the Broad Institute of Harvard and MIT in Cambridge, MA, USA, the Department of Clinical Sciences at Lund University in Malmö, Sweden, the Division of Epidemiology and Public Health at University of Nottingham, Nottingham City Hospital, the Nottingham Digestive Diseases Centre, NIHR Biomedical Research Unit in Nottingham, UK, the Department of Pediatrics, Örebro University Hospital in Örebro, Sweden, the Clinical Epidemiology Unit, Department of Medicine at Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden.
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    http://eurheartj.oxfordjournals.org/content/early/2011/06/07/eurheartj.ehr167.short?rss=1


    Jefferson Adams
    Celiac.com 07/10/2013 - Some doctors and nutritionists have expressed concern that a gluten-free diet might increase the risk of cardiovascular problems in patients with celiac disease.
    To get closer to an answer for this question, a team of researchers set out to assess changes of multiple cardiovascular risk factors in celiac patients evaluated before and during a gluten-free diet.
    The research team included B. Zanini, E. Mazzoncini, F. Lanzarotto, C. Ricci, B.M. Cesana, V. Villanacci, and A. Lanzini of the Gastroenterology Unit at the University and Spedali Civili in Brescia, Italy.
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    Compared to baseline, those following a gluten-free diet showed significantly higher body mass index (21.4±3.4 vs. 22.5±3.5; p
    While on the gluten-free diet, they also showed significantly lower levels in serum triglycerides (87.9±49.5 vs. 80.2±42.8mg/dL; p
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    Dig Liver Dis. 2013 May 17. pii: S1590-8658(13)00147-3. doi: 10.1016/j.dld.2013.04.001.


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