Gallstones favor infarcts

Gallstones affect the heart

20/11/2013

People with gallstones seem to be at increased risk for heart attacks and strokes. This is shown by the results of the German EPIC cohort. With about 50,000 participants, this study is the first large - scale study that has linked heart and brain infarcts.

In the past, physicians had suspected gallstones as possible causes of damage to blood vessels. In 1983, scientists in the evaluation of the so-called "Farming Heart Study" found evidence of the formation of atherosclerosis by gallstones. However, a relationship was found only in males, leading the researchers to believe that lipoprotein might favor vascular disease.

Gallstones are caused by a clumping of cholesterol or protein in the gallbladder or in the bile duct and are the basis of almost all diseases of the biliary tract.

Researchers from Mexico came to similar conclusions a few years ago and found an increased risk of infarction due to gallstones for both sexes.

Scientists from Canada had then detected a link between the metabolic syndrome and the occurrence of gallstones. The metabolic syndrome is now considered by medicine as a critical risk factor for coronary heart disease. One problem with the analysis of epidemiological data was the lack of truly representative studies.

With the European EPIC studies ("European Prospective Investigation Into Cancer and Nutrition"), in which also the data of the two subcohorts from Potsdam and Heidelberg with 46.486 participants flowed, meaningful results can now be included in the analysis.

Follow-up is based on the information provided by the patients
In a follow-up examination after just under eight years in the 919 patients were examined who had suffered either a myocardial infarction (heart attack) or a stroke, gallstones were found in 134 cases.

A total of 4828 gallstones were discovered and in 66.5 percent of those affected was then removed the gallbladder. According to the authors, however, the study is not entirely based on scientific criteria, because the information is largely based on the patients' statements. Other findings on gallstones may not have been reported, which may lead to a bias in prevalence. At any rate, the differences between the sexes and the regions are striking.

In women, gallstone prevalence was twice as high as in men, which was also reflected in the East-West comparison: In Potsdam, significantly more gallbladder was removed than in Heidelberg.

In addition, patients with gallstones had an almost two-point increased BMI index and were nearly five years older. They ate more meat and less exercise than the participants, who had not had any gallstones. High blood pressure and hyperlipidemia were also found more frequently in you.

The results show an up to 24 percent increased risk of heart attacks and insults in people with gallstones. However, it could not be confirmed that the hypothesis established by previous studies that removal of the gallbladder activates an increased cholesterol excretion and thereby also positively influences the lipid profile. After analyzing the analysis, German researchers come to the conclusion that this rather promotes fat accumulation in the organs and even increases the risk of atherosclerosis. Although some questions could not be clarified, the results of the analysis are an important reason for physicians in patients with gallstones to have even more of an eye on the risks of heart and vascular disease. (Fr)