Augmentation index is increased in patients with inflammatory bowel disease, a meta-analysis

Abstract

In a work published in a recent issue of the European Journal of Internal Medicine [ [1] Cappello M. Licata A. Calvaruso V. et al. Increased expression of markers of early atherosclerosis in patients with inflammatory bowel disease. Eur J Intern Med. 2017; 37: 83-89 Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar ], Cappello et al. found that, despite the lower prevalence of dyslipidemia, carotid-femoral pulse wave velocity, a measure of arterial stiffness, and augmentation index, a measure of wave reflection, were significantly increased in patients with inflammatory bowel disease (IBD), a disease characterized by chronic inflammation. This finding confirms the results of our previous works [ 2 Zanoli L. Cannavò M. Rastelli S. et al. Arterial stiffness is increased in patients with inflammatory bowel disease. J Hypertens. 2012; 30: 1775-1781https://doi.org/10.1097/HJH.0b013e3283568abd Crossref PubMed Scopus (72) Google Scholar , 3 Zanoli L. Rastelli S. Inserra G. et al. Increased arterial stiffness in inflammatory bowel diseases is dependent upon inflammation and reduced by immunomodulatory drugs. Atherosclerosis. 2014; 234: 346-351https://doi.org/10.1016/j.atherosclerosis.2014.03.023 Abstract Full Text Full Text PDF PubMed Scopus (55) Google Scholar ] and is of clinical interest because it helps explain why IBD patients have an increased cardiovascular risk despite the low prevalence of traditional cardiovascular risk factors [ [4] Zanoli L. Inserra G. Castellino P. Increased cardiovascular risk in subjects with a low prevalence of classic cardiovascular risk factors: the inflammatory bowel disease paradox. Trends Cardiovasc Med. 2015 Nov; 25: 705-706https://doi.org/10.1016/j.tcm.2015.04.001 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar ]. In this regard, the significantly higher augmentation index reported by Cappello et al. in IBD patients treated with salicylates are consistent with current evidences showing that chronic inflammation could play a role in the arterial stiffening of patients with IBD [ 2 Zanoli L. Cannavò M. Rastelli S. et al. Arterial stiffness is increased in patients with inflammatory bowel disease. J Hypertens. 2012; 30: 1775-1781https://doi.org/10.1097/HJH.0b013e3283568abd Crossref PubMed Scopus (72) Google Scholar , 3 Zanoli L. Rastelli S. Inserra G. et al. Increased arterial stiffness in inflammatory bowel diseases is dependent upon inflammation and reduced by immunomodulatory drugs. Atherosclerosis. 2014; 234: 346-351https://doi.org/10.1016/j.atherosclerosis.2014.03.023 Abstract Full Text Full Text PDF PubMed Scopus (55) Google Scholar , 4 Zanoli L. Inserra G. Castellino P. Increased cardiovascular risk in subjects with a low prevalence of classic cardiovascular risk factors: the inflammatory bowel disease paradox. Trends Cardiovasc Med. 2015 Nov; 25: 705-706https://doi.org/10.1016/j.tcm.2015.04.001 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar , 5 Zanoli L. Rastelli S. Granata A. et al. Arterial stiffness in inflammatory bowel disease: a systematic review and meta-analysis. J Hypertens. 2016; 34: 822-829https://doi.org/10.1097/HJH.0000000000000867 Crossref PubMed Scopus (39) Google Scholar , 6 Zanoli L. Rastelli S. Inserra G. Castellino P. Arterial structure and function in inflammatory bowel disease. World J Gastroenterol. 2015; 21: 11304-11311https://doi.org/10.3748/wjg.v21.i40.11304 Crossref PubMed Scopus (39) Google Scholar ]. This finding is also in accordance with the results of two recent meta-regression analyses that has suggested a lack of efficacy of salicylates in protecting IBD patients from arterial stiffening [ [7] Zanoli L, Boutouyrie P, Lentini P, et al. Maintenance therapy with salicylates is associated with aortic stiffening in patients with inflammatory bowel disease. J Hypertens [in press]. http://dx.doi.org/10.1097/HJH.0000000000001235. Google Scholar ] and the destiffening effect of anti-tumor necrosis factor α (anti-TNFα) therapy [ [5] Zanoli L. Rastelli S. Granata A. et al. Arterial stiffness in inflammatory bowel disease: a systematic review and meta-analysis. J Hypertens. 2016; 34: 822-829https://doi.org/10.1097/HJH.0000000000000867 Crossref PubMed Scopus (39) Google Scholar ].