Sarcoidosis Patients Seen to Be at Higher Than Usual Risk of Cardiovascular Disease

Sarcoidosis patients may be at a higher risk of cardiovascular disease than the general population — especially if patients have previous heart conditions, smoke, are overweight, or have diabetes, a study reports.

The findings were published in the European Respiratory Journal, in the article “Risk Of Cardiovascular Disease Among Patients With Sarcoidosis: A Population-Based Retrospective Cohort Study, 1976–2013.”

Chronic inflammation has been increasingly associated with a high risk of cardiovascular disease, as inflammatory molecules can damage blood vessels. However, its relationship with sarcoidosis remains elusive.

To investigate the comparative incidence of cardiovascular disease among these groups, researchers analyzed medical data of 345 sarcoidosis patients in Olmsted County, Minnesota, from 1976–2013, and of an equal number of gender- and age-matched healthy individuals (the control group) from the same population.

Records included data on coronary artery disease (CAD), congestive heart failure (CHF), atrial fibrillation, stroke, transient ischemic attack, peripheral arterial disease, and abdominal aortic aneurysm.

Initially, no significant difference between sarcoidosis patients and healthy individuals was found in terms of cardiovascular disease risk. But when researchers included in the analysis factors such as age and gender, they found that this risk rose significantly among sarcoidosis patients, and rose higher still for those with a previous cardiovascular history, such as coronary artery disease, congestive heart failure, atrial fibrillation and stroke (neither age nor gender were specified by the researches). This elevated risk continued to rise, albeit slightly, in those who were smokers, obese, or had diabetes, hypertension and high levels of fat in the blood (dyslipidemia).

“Premature atherosclerosis [blood vessel damage] associated with inflammation is probably the key driver behind this increased risk,” the researchers wrote. “While not specifically studied in sarcoidosis, it is likely that several inflammatory cytokines, such as interleukin-1 and tumour necrosis factor, contribute to [blood vessel damage] in this disease as well as other systemic inflammatory diseases through a number of mechanisms.”

“Glucocorticoids, the most commonly used medication in the management of sarcoidosis, may also be a contributing factor to the increased risk of [cardiovascular disease] as their long-term use is associated with several traditional [cardiovascular disease] risk factors, such as diabetes mellitus, hypertension and dyslipidemia,” they added.