While the link between inflammatory bowel disease (IBD) and cardiovascular disease (CVD) is established, long-term trends in cardiovascular mortality among IBD patients remain unclear. This nationwide study analyzed U.S. mortality data from 1999–2020 using the CDC’s Wide-ranging Online Data for Epidemiologic Research. We identified deaths with CVD as the underlying cause and IBD as a contributing factor, calculating age-adjusted mortality rates (AAMRs) by demographic and geographic factors. Among 11,891 CVD deaths linked to IBD, AAMRs declined significantly from 1999 to 2015 (−2.74% annually; p = 0.0064), then plateaued. Post-2015 increases were noted among Black individuals (+23.03%, 2017–2020; p = 0.0416) and men (+27.19%, 2018–2020; p = 0.0100). Mortality was highest among White and non-Hispanic populations, with regional variation. Forecasting models project rising mortality through 2040, especially among men and White individuals. These trends highlight persistent disparities and the need for targeted cardiovascular risk reduction in IBD populations.
JaiswalVBatraNDagarM, et al. Inflammatory bowel disease and associated cardiovascular disease outcomes: a systematic review. Medicine2023; 102(6): e32775.
2.
PiazzaGGoldhaberSZ.Venous thromboembolism and atherothrombosis: an integrated approach. Circulation2010; 121(19): 2146–2150.
3.
HanssonGK.Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med2005; 352(16): 1685–1695.
4.
SchichoRMarscheGStorrM.Cardiovascular complications in inflammatory bowel disease. Curr Drug Targets2015; 16(3): 181–188.
5.
PapaASantoliquidoADaneseS, et al. Increased carotid intima–media thickness in patients with inflammatory bowel disease. Aliment Pharmacol Ther2005; 22(9): 839–846.
6.
Cohen-HeymanNChodickG.Inflammatory bowel disease is associated with an increased risk of cardiovascular events in a sex and age-dependent manner: a historical cohort study. Int J Cardiol Cardiovasc Risk Prev2025; 24: 200363.
7.
MurthySKNguyenGC.Venous thromboembolism in inflammatory bowel disease: an epidemiological review. Am J Gastroenterol2011; 106(4): 713–718.
8.
DreganACharltonJChowienczykP, et al. Chronic inflammatory disorders and risk of type 2 diabetes mellitus, coronary heart disease, and stroke. Circulation2014; 130(10): 837–844.
9.
Dubois-CamachoKOttumPAFranco-MuñozD, et al. Glucocorticosteroid therapy in inflammatory bowel diseases: from clinical practice to molecular biology. World J Gastroenterol2017; 23(36): 6628–6638.
10.
CrowsonCSLiaoKPDavisJM, et al. Rheumatoid arthritis and cardiovascular disease. Am Heart J2013; 166(4): 622–628.e1.
11.
GrundySMStoneNJBaileyAL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APHA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: executive summary. J Am Coll Cardiol2018; 73(24): 3168–209.
12.
GhaferiAASchwartzTAPawlikTM.STROBE reporting guidelines for observational studies. JAMA Surg2021; 156(6): 577.
13.
SinghSSinghHLoftusEV, et al. Risk of cerebrovascular accidents and ischemic heart disease in patients with inflammatory bowel disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol2013; 12(3): 382–393.e1.
14.
FengWChenGCaiD, et al. Inflammatory bowel disease and risk of ischemic heart disease: an updated meta-analysis of cohort studies. J Am Heart Assoc2017; 6(8): e005892.
15.
KristensenSLAhlehoffOLindhardsenJ, et al. Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death—a Danish nationwide cohort study. PLoS One2013; 8(2): e56944.
16.
KristensenSLAhlehoffOLindhardsenJ, et al. Prognosis after first-time myocardial infarction in patients with inflammatory bowel disease according to disease activity. Circ Cardiovasc Qual Outcomes2014; 7(6): 857–862.
17.
AzizSAkhlaqAOwingsA, et al. Mortality trends in inflammatory bowel disease by age, sex, and race in the United States from 1999 to 2020. Inflamm Bowel Dis2024; 31(6): 1574–1582.
18.
AlchiraziKAHamidOQapajaT, et al. Racial disparities in utilization of medications and disease outcomes in inflammatory bowel disease patients. Crohns Colitis3602025; 7(2): otaf021.
19.
ShneydermanMFreidHKohlerD, et al. Management of overweight and obesity in patients with inflammatory bowel disease. Gastroenterol Hepatol2024; 20(12): 712–722.
20.
DeepakPBarnesELShaukatA.Health disparities in inflammatory bowel disease care driven by rural versus urban residence: challenges and potential solutions. Gastroenterology2023; 165(1): 11–15.
21.
ZammarchiILanzarottoFCannatelliR, et al. Elderly-onset vs adult-onset ulcerative colitis: a different natural history?BMC Gastroenterol2020; 20(1): 147.
22.
SousaPBertaniLRodriguesC.Management of inflammatory bowel disease in the elderly: a review. Dig Liver Dis2023; 55(8): 1001–1009.
23.
Cainzos-AchiricaMGlassnerKZawahirHS, et al. Inflammatory bowel disease and atherosclerotic cardiovascular disease. J Am Coll Cardiol2020; 76(24): 2895–2905.
24.
NasirKAcquahIDeyAK, et al. Inflammatory bowel disease and atherosclerotic cardiovascular disease in U.S. adults—a population-level analysis in the national health interview survey. Am J Prev Cardiol2022; 9: 100316.
25.
ShehabMAlrashedFAlkazemiA, et al. Impact of biologic therapies and small molecules on the risk of major adverse cardiovascular events in patients with inflammatory bowel diseases: systematic review and meta-analysis of randomized controlled trials. Expert Rev Gastroenterol Hepatol2023; 17(5): 469–477.
26.
RoigCAFerrerCSGarcíaJLR, et al. Influencia del tratamiento biológico en los factores de riesgo cardiovascular de los pacientes con enfermedad inflamatoria intestinal. Gastroenterol Hepatol2022; 46(2): 109–115.
27.
ZhuFBoersmaETillyM, et al. Trends in population attributable fraction of modifiable risk factors for cardiovascular diseases across three decades. Eur J Prev Cardiol2024; 31(14): 1724–1733.
