Gastroenteritis and long term risk of cardiovascular and renal disease

January 01, 0001

Gastroenteritis and long term risk of cardiovascular and renal disease

In May of 2000 there was a focal outbreak of Escherichia coli O157:H7 and Campylobacter in Ontario, Canada. These Canadian researchers enrolled 1977 patients who were exposed to contaminated drinking water in a prospective cohort study and followed them for eight years. Surveys were collected yearly along with physical examinations and laboratory data to test for gastroenteritis, hypertension, cardiovascular disease, and renal impairment.

The researchers found: "Acute gastroenteritis at the time of the outbreak was reported by 1067 (54%) of participants. Incident hypertension was detected in 697 (35%) (294 (32%) of group not exposed to acute gastroenteritis v 403 (38%) of exposed group). While 572 (29%) had at least one indicator of renal impairment (266 (29%) of unexposed v 306 (29%) of exposed), only 30 (1.5%) had both (8 (0.9%) of unexposed v 22 (2.1%) of exposed). Cardiovascular disease was reported by 33/1749 (1.9%). The adjusted hazard ratios for hypertension and cardiovascular disease after acute gastroenteritis were 1.33 and 2.13 respectively. The adjusted hazard ratio for the presence of either indicator of renal impairment was 1.15 and was 3.41 for the presence of both."

The researchers concluded: "Gastroenteritis from drinking water contaminated with E coli O157:H7 and Campylobacter was associated with an increased risk for hypertension, renal impairment, and self reported cardiovascular disease. Annual monitoring of blood pressure and periodic monitoring of renal function may be warranted for individuals who experience E coli O157:H7 gastroenteritis."

This study suggests there is some longer term risk of cardiovascular and renal disease following Escherichia coli O157:H7 and Campylobacter gastroenteritis

For the full abstract, click here.

BMJ 341:c6020, 17 November 2010 © 2010 Clark et al.
Long term risk for hypertension, renal impairment, and cardiovascular disease after gastroenteritis from drinking water contaminated with Escherichia coli O157:H7: a prospective cohort study. William F Clark, Jessica M Sontrop, Jennifer J Macnab, et al. Correspondence to W F Clark: [email protected]

Category: K. Circulatory, U. Urinary System. Keywords: Escherichia coli O157:H7, Campylobacter, gastroenteritis, cardiovascular disease, renal disease, prospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 3 December 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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