Acute Gastroenteritis May Lead to Heart Disease

Individuals who have become infected with E. coli 0157:H7 and/or Campylobacter and suffered from acute gastroenteritis may have an increased risk of chronic diseases associated with high blood pressure and renal impairment.

An assessment was made at Victoria Hospital, (London, Ontario, Canada), of 4,561 people who had been exposed to a tainted municipal water system in May 2000. The water had been infected with Campylobacter and E. coli 0157:H7 bacteria. The long-term health of 1,977 individuals who had developed gastroenteritis was evaluated as 1,067 of them became ill with acute gastroenteritis, and 378 sought help from a physician. Of the 131 stool samples tested for pathogens, 19% were positive for E. coli O157:H7, 19% were positive for Campylobacter, and 1.5% showed coinfection. This prospective cohort study was conducted from 2002 until 2008.

Structural and functional renal impairment were defined as microalbuminuria (albumin:creatinine ratio greater than 2.0 mg/mmol in men and more than 2.8 mg/mmol in women) and estimated glomerular filtration rate less than 60 mL/min/1.73 m², respectively. Two classifications of renal impairment were analyzed: the presence of either indicator of renal impairment and the presence of both indicators.

The investigators discovered that those who had developed gastroenteritis symptoms had a 1.3 higher risk of developing hypertension (high blood pressure) compared to those who had not become infected. Renal impairment (kidney problem) risk was 3.4 times higher, and the chances of having a cardiovascular event, such as stroke or heart attack were 2.1 times higher. Recent research suggests that the presence of both structural and functional renal impairment is a stronger predictor of mortality, cardiovascular morbidity, and renal decline than either structural or functional renal impairment alone.

The authors concluded that their findings underline the need for following up individual cases of food or water poisoning by E. coli O157:H7 to prevent or reduce silent progressive vascular injury. These long-term consequences emphasize the importance of ensuring safe food and water supply as a cornerstone of public health.

The study was published November 17, 2010, in the British Medical Journal.

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Victoria Hospital