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Constipation and risk of cardiovascular diseases: a Danish population-based matched cohort study.

ABSTRACT: OBJECTIVES:To assess the risks of myocardial infarction, stroke, peripheral artery disease, venous thromboembolism, atrial fibrillation or atrial flutter and heart failure in patients with constipation compared with a general population cohort. DESIGN:Population-based matched cohort study. SETTING:All Danish hospitals and hospital outpatient clinics from 2004 to 2013. PARTICIPANTS:Patients with a constipation diagnosis matched on age, sex and calendar year to 10 individuals without constipation from the general population. MAIN OUTCOMES MEASURES:Comorbidity-adjusted and medication-adjusted hazard ratios (aHRs) for cardiovascular outcomes based on Cox regression analysis. RESULTS:83?239 patients with constipation were matched to 832?384 individuals without constipation. The median age at constipation diagnosis was 46.5% and 41% were men. Constipation was strongly associated with venous thromboembolism (aHR 2.04, 95% CI 1.89 to 2.20), especially splanchnic venous thrombosis (4.23, 95%?CI 2.45 to 7.31). Constipation was also associated with arterial events, including myocardial infarction (1.24, 95%?CI 1.14 to 1.35), ischaemic stroke (1.50, 95%?CI 1.41 to 1.60), haemorrhagic stroke (1.46, 95%?CI 1.26 to 1.69), peripheral artery disease (1.34, 95%?CI 1.20 to 1.50), atrial fibrillation or atrial flutter (1.27, 95%?CI 1.20 to 1.34) and heart failure (1.52, 95%?CI 1.42 to 1.62). The associations were strongest during the first year after the constipation diagnosis and strengthened with an increased number of laxative prescriptions. CONCLUSIONS:Constipation was associated with an increased risk of several cardiovascular diseases, in particular venous thromboembolism.

SUBMITTER: Sundboll J

PROVIDER: S-EPMC7473662 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Constipation and risk of cardiovascular diseases: a Danish population-based matched cohort study.

Sundbøll Jens J Szépligeti Szimonetta Komjáthiné SK Adelborg Kasper K Szentkúti Péter P Gregersen Hans H Sørensen Henrik Toft HT

BMJ open 20200901 9

<h4>Objectives</h4>To assess the risks of myocardial infarction, stroke, peripheral artery disease, venous thromboembolism, atrial fibrillation or atrial flutter and heart failure in patients with constipation compared with a general population cohort.<h4>Design</h4>Population-based matched cohort study.<h4>Setting</h4>All Danish hospitals and hospital outpatient clinics from 2004 to 2013.<h4>Participants</h4>Patients with a constipation diagnosis matched on age, sex and calendar year to 10 indi ...[more]

PMID: 32873621

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Project description:OBJECTIVE:To examine the risks of myocardial infarction, stroke (ischaemic and haemorrhagic), peripheral artery disease, venous thromboembolism, atrial fibrillation or atrial flutter, and heart failure in patients with migraine and in a general population comparison cohort. DESIGN:Nationwide, population based cohort study. SETTING:All Danish hospitals and hospital outpatient clinics from 1995 to 2013. PARTICIPANTS:51 032 patients with migraine and 510 320 people from the general population matched on age, sex, and calendar year. MAIN OUTCOME MEASURES:Comorbidity adjusted hazard ratios of cardiovascular outcomes based on Cox regression analysis. RESULTS:Higher absolute risks were observed among patients with incident migraine than in the general population across most outcomes and follow-up periods. After 19 years of follow-up, the cumulative incidences per 1000 people for the migraine cohort compared with the general population were 25 v 17 for myocardial infarction, 45 v 25 for ischaemic stroke, 11 v 6 for haemorrhagic stroke, 13 v 11 for peripheral artery disease, 27 v 18 for venous thromboembolism, 47 v 34 for atrial fibrillation or atrial flutter, and 19 v 18 for heart failure. Correspondingly, migraine was positively associated with myocardial infarction (adjusted hazard ratio 1.49, 95% confidence interval 1.36 to 1.64), ischaemic stroke (2.26, 2.11 to 2.41), and haemorrhagic stroke (1.94, 1.68 to 2.23), as well as venous thromboembolism (1.59, 1.45 to 1.74) and atrial fibrillation or atrial flutter (1.25, 1.16 to 1.36). No meaningful association was found with peripheral artery disease (adjusted hazard ratio 1.12, 0.96 to 1.30) or heart failure (1.04, 0.93 to 1.16). The associations, particularly for stroke outcomes, were stronger during the short term (0-1 years) after diagnosis than the long term (up to 19 years), in patients with aura than in those without aura, and in women than in men. In a subcohort of patients, the associations persisted after additional multivariable adjustment for body mass index and smoking. CONCLUSIONS:Migraine was associated with increased risks of myocardial infarction, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, and atrial fibrillation or atrial flutter. Migraine may be an important risk factor for most cardiovascular diseases.

Dataset Information

Constipation and risk of cardiovascular diseases: a Danish population-based matched cohort study.

Publications

Constipation and risk of cardiovascular diseases: a Danish population-based matched cohort study.

Similar Datasets

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