Gallstones and risk of coronary heart disease: prospective analysis of 270,000 men and women from 3 US cohorts and meta-analysis

Abstract

Objective Gallstone disease has been related to cardiovascular risk factors; however, whether presence of gallstones predicts coronary heart disease (CHD) is not well established.Approach and Results We followed up 269142 participants who were free of cancer and cardiovascular disease at baseline from 3 US cohorts: the Nurses' Health Study (112520 women; 1980-2010), Nurses' Health Study II (112919 women; 1989-2011), and the Health Professionals Follow-up Study (43703 men; 1986-2010) and documented 21265 incident CHD cases. After adjustment for potential confounders, the hazard ratio for the participants with a history of gallstone disease compared with those without was 1.15 (95% confidence interval, 1.10-1.21) in Nurses' Health Study, 1.33 (95% confidence interval, 1.17-1.51) in Nurses' Health Study II, and 1.11 (95% confidence interval, 1.04-1.20) in Health Professionals Follow-up Study. The associations seemed to be stronger in individuals who were not obese, not diabetic, or were normotensive, compared with their counterparts. We identified 4 published prospective studies by searching PUBMED and EMBASE up to October 2015, coupled with our 3 cohorts, involving 842553 participants and 51123 incident CHD cases. The results from meta-analysis revealed that a history of gallstone disease was associated with a 23% (15%-33%) increased CHD risk.Conclusion Our findings support that a history of gallstone disease is associated with increased CHD risk, independently of traditional risk factors.