Ankylosing Spondylitis And Heart Disease: How Is It Linked?

Chest Pain

Ankylosing spondylitis is a type of inflammatory infection affecting mainly the spine as well as other joints in the body.

Over time, the condition may cause fusing of some of the vertebrae in your spine making it less flexible and eventual hunching of the back. In serious cases, if the infection affects the ribs, breathing too becomes a problem.

This condition has a major impact on different aspects of your health, but what is the link between ankylosing spondylitis and heart function? Scroll down to find out.

What is Ankylosing spondylitis?

According to the Spondylitis Association of America[1], the condition is affecting more people than rheumatoid arthritis, autism, and multiple sclerosis even though it continues to remain relatively unknown to many! Actually, there is at least one American in every 1000, suffering from spondylo arthritis with a majority of the patients forced to change their careers due to the same condition.

At the onset of ankylosing spondylitis, such symptoms as pain and stiffness are common especially in the lower back and hips during periods of inactivity and mornings. The pain may as well spread through the spine affecting the neck and upper back.

As time goes by the symptoms of the condition may get worse, get better or even stop at specific periods.

Spine And  Pelvis

The condition is commonly known to affect the following areas:

  • Joints between the base of your spine and the pelvis
  • Places where tendons and ligaments attach to the bones especially on the spine
  • Cartilages between the breastbone and the ribs
  • Hips and shoulder joints
  • Vertebrae in the lower back

Though the main cause of this condition is unknown, genetic factors have been said to be involved particularly for people with a gene referred to as HLA-B27.

However, not all people with the gene develop the condition. Other risk factors for ankylosing spondylitis include gender and age.

While men are more likely to develop ankylosing spondylitis as compared to women, the age at which people are likely to develop it is around late adolescence and early adulthood.

Does Ankylosing Spondylitis cause Heart Disease?

Ankylosing Spondylitis cause Heart Disease

Researchers are still trying to understand how ankylosing spondylitis and heart disease are linked. According to clinical and epidemiological research studies[2], AS patients are at a 30-50% increased risk of heart disease among other complications like stroke, conduction disturbance, aortic valve disease, aortitis, and cardiomyopathy.

A study whose findings were published in the Annals of Translational Medicine[3] found that ankylosing spondylitis patients were 41% more likely to develop coronary artery disease. Although there is still a lot to learn about this relationship, scientists explain that main culprit is chronic inflammation of the endothelial cell integrity.

Endothelial cells are the cells that line the interior surface of blood and lymphatic vessels.

When it comes to ankylosing spondylitis and heart relationship, one study[4] found that female patients with this condition were more likely to develop coronary artery disease. Interestingly, the study also found that the use of NSAIDs decreased* this risk.

The Journal of Clinical Medicine Research[5] published a study which made its contribution to the growing body of evidence confirming the relationship between this condition and heart disease.

The study showed that the effects of AS on the cardiovascular system affect mortality and morbidity of a patient.

Scientists recommend that if chest pain occurs in high-risk individuals, doctors should consider aortic dissection and perform necessary treatment options to alleviate the problem.

Moreover, the exam for cardiovascular disease should be recommended to AS patients, particularly to those who have been dealing with this condition for long-term and individuals who are HLA-B27-positive.

Effects of Ankylosing Spondylitis

What is the link between Ankylosing Spondylitis and Heart Disease?

Ankylosing Spondylitis is also referred to as spinal arthritis which is an autoimmune disease where inflammation plays a major role.

That being said, inflammation also has a lot to do with heart disease and risks factors that contribute to it.

Besides inflammation, other factors like the medications used in treating AS especially the non-steroidal anti-inflammatory drugs (NSAIDs) may elevate the risks of heart disease.

It is indeed a vicious cycle whereby inflammation may result in cardiovascular problems, and then the treatment administered in reducing* the inflammation increases* the risk even further!

Since NSAIDs decreased* the risk of heart disease in female patients, it is evident the link between these two conditions is more complex and patients should consult their doctors regarding intake of any medication.

Yet another link between ankylosing spondylitis and heart disease is the fact that chronic inflammation is strongly associated with the thrombophilic state[6], an abnormality of blood coagulation that elevates the risk of thrombosis (blood clots).

On the other hand, people with AS are likely to have high blood sugar, high cholesterol and many of them are overweight or
obese. All these are indeed factors that also increase* risks of heart disease. Lastly, ankylosing spondylitis is said to cause problems with the aorta which is the largest artery in the body.

Once the aorta is inflamed, it enlarges affecting the shape of the aortic valve in the heart impairing proper functioning. This may result in various cardiovascular problems including stroke and heart disease.

What are the Heart complications in AS patients?

Heart Complications

The Spondylitis Association of America identified common heart-related complications in patients with this condition. They include:

  • Aortitis – Inflammation of the aorta; most AS patients have chronic inflammation at the base of the heart, around the aortic valve, and at the origin of your aorta.
  • Conduction disturbances – Arrhythmias that causes the heart that beat too fast or too slow.
  • Cardiomyopathy – Disease that enlarges and weakens the heart muscle, making it difficult to pump blood to the rest of the body.

Read Next: What Is The Connection Between Heart Disease & Water Retention?


Ankylosing spondylitis can be quite a debilitating condition especially if effective interventions are not taken into account early enough.

In severe cases, this condition has been observed to lead to even more serious complications such as heart disease, uveitis compression fractures among others.

Having learned how ankylosing Spondylitis and heart problems are inked, it is time you started taking care of your heart by watching out on your spinal and general health of the body.

Do not let the effects of AS on your cardiovascular system affect your mortality and morbidity; take charge of your health now and get diagnosed so that you can manage the condition properly as guided by a professional medical doctor.

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Expert Author : Dr. Ahmed Zayed (Consumer Health Digest)

Dr. Ahmed Zayed Helmy holds a baccalaureate of Medicine and Surgery. He has completed his degree in 2011 at the University of Alexandria, Egypt. Dr. Ahmed believes in providing knowledgeable information to readers. Other than his passion for writing, currently he is working as a Plastic surgeon and is doing his masters at Ain shams University.

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