A recent study published in Journal of Translational Internal Medicine (https://doi.org/10.1515/jtim-2024-0017) reveals important insights into the broader impact of GERD on cardiovascular health. Using a rigorous two-way Mendelian randomization (MR) approach, the research provides essential evidence that GERD—a condition traditionally recognized as a digestive disorder characterized by acid reflux and heartburn—may affect key cardiovascular risk factors, including blood pressure, lipid profiles and heart disease risk.
This groundbreaking study suggests that the effects of GERD may extend beyond the digestive system, potentially playing an important role in cardiovascular health. “Our research highlights that GERD can significantly affect cardiovascular risk, offering a more comprehensive view of its influence,” said Qiang Wu, from the Senior Cardiology Department at the Sixth Medical Center of PLA Chinese General Hospital in Beijing, China.
The use of two-way Mendelian randomization provides an advantage over traditional studies by controlling for confounding factors and addressing reverse causality. This approach, which uses genetic data to make causal inferences, provides a stronger basis for understanding how GERD may affect cardiovascular outcomes. Genetic variants associated with GERD were used as organ variables, allowing researchers to investigate the potential causative role of GERD in cardiovascular disease more precisely, according to Qiang Su, from the Department of Cardiology at Jiangbin Hospital of Guangxi Zhuang Autonomous Region. The study applied a two-sample MRI approach, drawing data from genome-wide association studies (GWAS) involving more than 600,000 participants, including 129,000 diagnosed cases of GERD, while cardiovascular data was obtained from a European cohort of more than 200,000 people. The researchers focused on basic blood pressure measurements such as systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and mean arterial pressure (MAP).
The study used several advanced MRI techniques, including inverse variance weighted (IVW) analysis, MR Egger regression, and the weighted median approach. These methods checked for pleiotropic effects, where one gene affects multiple traits, thus enhancing the reliability of the findings. This rigorous approach led the researchers to conclude that GERD could significantly affect cardiovascular risk factors, particularly blood pressure and lipid levels.
One of the most notable findings of the study was a strong association between GERD and elevated blood pressure. The researchers observed that genetically predisposed GERD was associated with higher systolic blood pressure (SBP) (β = 0.053, P = 0.036) and diastolic blood pressure (DBP) (β = 0.100, P < 0.001), suggesting that GERD would could worsen high blood pressure - a major risk factor for heart disease and stroke.
Regarding lipid profiles, the study showed that GERD was associated with increased levels of low-density lipoprotein (LDL) cholesterol (β = 0.093, P < 0.001) and triglycerides (β = 0.153, P < 0.001), which are associated with higher risk of cardiovascular disease. In contrast, GERD was inversely associated with high-density lipoprotein (HDL) cholesterol (β = -0.115, P = 0.002), often considered the “good” cholesterol that protects against heart disease.
In addition, research has shown that GERD increases the risk of cardiovascular diseases such as myocardial infarction (heart attack) and high blood pressure. Specifically, the odds ratio for myocardial infarction was 1.272 (95% CI: 1.040 to 1.557, P = 0.019) and for hypertension was 1.357 (95% CI: 1.222 to 1.507, P < 0). However, no significant association was found between GERD and heart failure.
These findings suggest that GERD may be a potential risk factor for cardiovascular disease. By revealing these associations, our study highlights the importance of early diagnosis and prevention strategies for both GERD and CVD.”
Qiang Su of Jiangbin Hospital
This study highlights the need for increased awareness of the potential cardiovascular effects of GERD. As millions are affected by GERD worldwide, these findings could encourage healthcare providers to adopt more proactive approaches for people at risk.
Source:
Journal Reference:
Wu, Q., et al. (2024). Gastroesophageal reflux disease affects blood pressure components, lipid profile, and cardiovascular disease: Evidence from a Mendelian randomized study. Journal of Translational Internal Medicine. doi.org/10.1515/jtim-2024-0017.
