Key result
Adult congenital heart disease is linked to ~30% higher risk of diabetes mellitus versus controls.
Why the study?
ASCVD risk in adults with congenital heart disease is comparable to the general population and driven by traditional risk factors, but the exact prevalence of these risk factors compared with the general population required estimation.
Meta-Analysis (n=110,469)
Yes
Adults with congenital heart disease have a similar prevalence of traditional ASCVD risk factors to the general population, aside from higher diabetes and lower smoking rates, underscoring the need for systematic risk factor screening and management.
Supports targeted diabetes screening in adults with congenital heart disease; extends risk factor profiling in this growing population.
Background: The risk of atherosclerotic cardiovascular disease (ASCVD) in adults with congenital heart disease (ACHD) is comparable to that of the general population and is driven by traditional ASCVD risk factors. Objectives: The aim of the study was to estimate the prevalence of traditional ASCVD risk factors (hypertension, dyslipidemia, diabetes mellitus [DM], obesity, smoking, and physical inactivity) in ACHD and compare it with the general population. Methods: A systematic literature search was conducted up to May 15, 2024, to identify studies (with or without control group) reporting the prevalence of ASCVD risk factors in ACHD. Meta-analyses were conducted to synthesize the prevalence of risk factors and compare it with that of the general population, where applicable. Results: We identified 62 studies (30 controlled) encompassing 110,469 ACHD (mean age 39 years; 52% males, 88% with simple/moderate congenital heart disease complexity). Of these, 54% (45%-63%) reported lack of regular exercise, 33% (26%-40%) had hypertension, 18% (14%-22%) were obese, 17% (11%-25%) had dyslipidemia, 12% (9%-14%) were current smokers, and 7% (5%-9%) had DM. The prevalence of ASCVD risk factors was similar in ACHD and controls, with the exception of DM (higher prevalence in ACHD) and smoking (lower prevalence in ACHD). Significant heterogeneity was observed among the included studies, partially explained by differences in age, congenital heart disease complexity, and the presence of cyanosis. Conclusions: Except for DM and smoking, the prevalence of traditional ASCVD risk factors is similar in ACHD compared to the general population. Further research is needed to determine whether interventions applied in the general population are also effective in ACHD.
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Papazoglou et al. (2024) conducted a meta-analysis in Congenital heart disease (n=110,469). Congenital heart disease vs. General population controls was evaluated on Prevalence of diabetes mellitus compared to general population controls (RR 1.30, 95% CI 1.09-1.55). Adults with congenital heart disease had a higher risk of diabetes mellitus (RR 1.30) and a lower frequency of smoking (RR 0.67) compared to the general population, with similar rates of hypertension, dyslipidemia, and obesity.
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