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. 2011 Aug;124(8):714-23.
doi: 10.1016/j.amjmed.2011.03.026. Epub 2011 Jun 12.

Constipation and risk of cardiovascular disease among postmenopausal women

Elena Salmoirago-Blotcher  1 , Sybil Crawford, Elizabeth Jackson, Judith Ockene, Ira Ockene
Affiliations

Constipation and risk of cardiovascular disease among postmenopausal women

Elena Salmoirago-Blotcher et al. Am J Med. 2011 Aug.

Abstract

Background: Constipation is common in Western societies, accounting for 2.5 million physician visits/year in the US. Because many factors predisposing to constipation also are risk factors for cardiovascular disease, we hypothesized that constipation may be associated with increased risk of cardiovascular events.

Methods: We conducted a secondary analysis in 93,676 women enrolled in the observational arm of the Women's Health Initiative. Constipation was evaluated at baseline by a self-administered questionnaire. Estimates of the risk of cardiovascular events (cumulative end point including mortality from coronary heart disease, myocardial infarction, angina, coronary revascularization, stroke, and transient ischemic attack) were derived from Cox proportional hazards models adjusted for demographics, risk factors, and other clinical variables (median follow-up 6.9 years).

Results: The analysis included 73,047 women. Constipation was associated with increased age, African American and Hispanic descent, smoking, diabetes, high cholesterol, family history of myocardial infarction, hypertension, obesity, lower physical activity levels, lower fiber intake, and depression. Women with moderate and severe constipation experienced more cardiovascular events (14.2 and 19.1 events/1000 person-years, respectively) compared with women with no constipation (9.6/1000 person-years). After adjustment for demographics, risk factors, dietary factors, medications, frailty, and other psychological variables, constipation was no longer associated with an increased risk of cardiovascular events except for the severe constipation group, which had a 23% higher risk of cardiovascular events.

Conclusion: In postmenopausal women, constipation is a marker for cardiovascular risk factors and increased cardiovascular risk. Because constipation is easily assessed, it may be a helpful tool to identify women with increased cardiovascular risk.

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Conflict of interest statement

All authors had access to the data and were significantly involved in the preparation of this manuscript. No honorarium, grant, or other form of payment was given to anyone to produce this manuscript and the authors report no conflict of interest.

Figures

Figure 1
Figure 1
Cumulative incidence of cardiovascular events by baseline constipation
See this image and copyright information in PMC

Comment in

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