Associations of Bowel Movement Frequency with Risk of Cardiovascular Disease and Mortality among US Women.

Wenjie Ma,Kathryn M Rexrode,Yanping Li,Eric B Rimm,Yoriko Heianza,Kyle D Staller,Lu Qi,Andrew T Chan

doi:10.1038/srep33005

Abstract

Emerging evidence suggests a potential impact of gastrointestinal function on cardiometabolic risk. Abnormal bowel movements have been related to various cardiovascular risk factors such as dyslipidemia, hypertension, diabetes, and altered metabolism of bile acids and gut microbiota. However, little is known about whether bowel movement frequency affects risk of cardiovascular disease (CVD) and mortality. In the Nurses’ Health Study, bowel movement frequency was self-reported in 1982 by 86,289 women free from CVD and cancer. During up to 30 years of follow-up, we documented 7,628 incident CVD cases and 21,084 deaths. After adjustment for dietary intake, lifestyle, medication use, and other risk factors, as compared with women with daily bowel movement, having bowel movements more than once daily was significantly associated with increased risk of CVD (hazard ratio [HR]: 1.13; 95% confidence interval [CI]: 1.05–1.21), total mortality (HR: 1.17; 95% CI: 1.12–1.22), and cardiovascular mortality (HR: 1.17; 95% CI: 1.07–1.28). With further adjustment for body mass index and diabetes status, the association with total mortality remained significant (HR: 1.10; 95% CI: 1.06–1.15), whereas the associations with incident CVD and cardiovascular mortality were no longer significant. Our results suggest increased bowel movement frequency is a potential risk factor for premature mortality.

Highlights

IntroductionRecently emerging evidence suggests that GI function may play a greater role than previously thought[1]
With further adjustment for body mass index and diabetes status, the association with total mortality remained significant (HR: 1.10; 95% confidence interval (CI): 1.06–1.15), whereas the associations with incident cardiovascular disease (CVD) and cardiovascular mortality were no longer significant
Abnormal bowel movement frequency occurring in irritable bowel syndrome and functional constipation has been related to a variety of cardiovascular risk factors including elevated circulating levels of cholesterol and triglycerides, hypertension, diabetes, and altered bile acid metabolism[18,19,20,21,22,23,24,25]

Summary

Introduction

Recently emerging evidence suggests that GI function may play a greater role than previously thought[1] Several digestive diseases, such as inflammatory bowel disease and gallstone disease, have been associated with an increased risk of cardiovascular disease (CVD)[2,3,4,5] as well as various cardiometabolic risk factors such as obesity, inflammation, dyslipidemia, and insulin resistance[6,7]. Abnormal bowel movement frequency occurring in irritable bowel syndrome and functional constipation has been related to a variety of cardiovascular risk factors including elevated circulating levels of cholesterol and triglycerides, hypertension, diabetes, and altered bile acid metabolism[18,19,20,21,22,23,24,25]. Because bowel movement frequency is affected by dietary and lifestyle factors, we examined whether these factors modified the associations

Methods

Results

Conclusion