Abstract Background Although increasing evidence has linked inflammatory bowel diseases (IBD) to heightened cardiovascular disease (CVD) risk, the national, regional, and global burden of CVD attributable to IBD has not been systematically quantified. Herein, we evaluated CVD risk among individuals with IBD and estimated the incidence of CVD attributable to IBD. Methods We conducted a systematic literature review and meta-analysis to examine the risk of CVD among patients with IBD. Leveraging IBD prevalence data from GBD 2021 and the region-specific relative risk (RR), we modeled the population attributable fraction (PAF). Furthermore, we calculated the age-standardized incidence rate (ASIR) and the estimated annual percentage change (EAPC) of CVD attributable to IBD. Results Thirty-one studies met our inclusion criteria, with 36,971 cases of CVD observed among 1,059,715 individuals with IBD. The risk of developing CVD was significantly higher among individuals with IBD (RR 1.27; 95% CI: 1.19-1.34), UC (RR 1.22; 95% CI: 1.15-1.29), and CD (RR 1.32; 95% CI: 1.21-1.45) compared with those without IBD. IBD patients exhibited an 11%-76% higher risk of stroke, coronary heart disease, ischemic heart disease, myocardial infarction, heart failure, cardiomyopathy, and myocarditis, with cardiomyopathy presenting the greatest excess risk. In 2021, 8,503 new cases of CVD were attributable to IBD globally, representing a 1.83-fold increase over the past 30 years, with the highest PAF observed in North America. Europe & Central Asia recorded the highest number of new CVD attributable to IBD cases in 2021, while North America had the highest ASIR. Notably, the ASIR of CVD attributable to IBD increased in East Asia & Pacific, South Asia, Middle East & North Africa, and Sub-Saharan Africa, with EAPC of 1.03%, 0.59%, 0.44%, and 0.28%, respectively. Approximately 53.4% (109 out of 204) of countries and territories exhibited an increasing trend in CVD attributable to IBD ASIR from 1990 to 2021, with China exhibiting the most rapid increase. Conclusion IBD confers an excess risk of CVD, with a rising and uneven global burden, underscoring the need for integrated prevention and management. Conflict of interest: Dr. Zhao, Jianhui: I acknowledge support from the Key Laboratory of Integrated Care for Geriatric Chronic Diseases (Kunming Medical University, School of Nursing), Yunnan Provincial Education Department (Grant No. 2024HTHLYB05), and from the Fundamental Research Funds for the Central Universities (No. 2024BSSXM20). I declare no other conflicts of interest. Li, Xue: No conflict of interest
Zhao et al. (Thu,) studied this question.