Research shows a link between ankylosing spondylitis and heart disease. Taking steps to protect your heart health today can help prevent more heart problems in the future.
Although ankylosing spondylitis (AS) involves chronic inflammation of the joints in your spine, it’s possible for this form of progressive arthritis to affect other organs, including your heart. Fortunately, the odds of that happening are rare, but experts have said that taking steps to protect your heart health now can help ensure that you are not increasing your risk for heart problems down the road.
The Link Between Ankylosing Spondylitis and Heart Disease
Research shows that up to 10 percent of people with ankylosing spondylitis develop certain heart complicationsand that there’s also an ankylosing spondylitis and stroke connection: AS can increase your risk for stroke by as much as 25 percent.
“This is an autoimmune condition that is associated with very specific cardiac abnormalities,” explained Binh An Phan, MD, a cardiologist and assistant professor of medicine and cardiology at the Loyola University’s Stritch School of Medicine in Chicago. “Among the areas the antibodies attack is the tissue surrounding the aortic valve.”
Dr. Phan noted that years of chronic inflammation can lead to valve leakage or aortic regurgitation, a condition that occurs when the aortic valve does not close properly, causing blood to flow backward. Over time, untreated aortic regurgitation can lead to congestive heart failure.
AS can also lead to an electrical or conduction problem in the heart, Phan added. “The antibodies that attack the tissues of the heart interfere with the ability of the heart to send out electrical impulses,” he explained. “With a conduction abnormality, patients can develop slow heart rate and symptoms such as difficulty breathing, chest discomfort, lightheadedness, and shortness of breath.”
People with ankylosing spondylitis are at increased of heart attack and stroke.
A 2008 study conducted by researchers in Italy revealed that aortic regurgitation and conduction disturbances were the most common heart complications associated with ankylosing spondylitis. The study’s authors pointed out that less common heart problems involving the coronary arteries could also occur.
AS and Heart Attack Risk: Coronary Artery Health
“Current data suggest rates of cardiovascular disease, including heart attacks and stroke, are increased in those with ankylosing spondylitis as compared to the general population,” said Grant H. Louie, MD, a rheumatologist and assistant professor of medicine in the division of rheumatology at Johns Hopkins University in Baltimore. “The chronic inflammation from the disease can damage the lining of the arterial wall. Over time, this can lead to plaque formation, or atherosclerosis.”
A 2011 study in Arthritis & Rheumatism found that AS increases coronary artery disease risk by 37 percent. The study was conducted over the course of a decade and compared health data on 8,616 people in Quebec diagnosed with AS with the general population. The researchers also found that people with AS have a 58 percent increased risk for heart valve disease and a 25 percent higher risk for stroke, with the greatest risks being among those 20 to 39 years old.
Common Painkillers’ Role in Heart Complications
Non-steroidal anti-inflammatory drugs (NSAIDs), often used to treat ankylosing spondylitis and as painkillers, may also play a role in increasing the risk of heart disease, according to Dr. Louie.
Research published in May 2013 in The Lancet reviewed 639 randomized trials involving more than 353,000 people and found that taking high doses of NSAIDs, such as 2,400 mg of ibuprofen daily, increases the risk for non-fatal heart attacks, strokes, and early death by roughly a third.
The researchers found that for every 1,000 people with a moderate risk for heart disease, three would have an avoidable heart attack after taking high doses of NSAIDs for a year.