Congenital heart defects dramatically increase the risk of heart problems later in life

An infant born with a relatively simple heart defect is much more likely to develop heart problems in adulthood, researchers at Stanford University School of Medicine have found.

The risk is so great that a person born with a heart defect who leads a heart-healthy lifestyle is twice as likely to develop heart problems as someone born without a defect who leads a heart-healthy lifestyle.

“All of us in cardiology recognize that people with complex disease need lifelong follow-up care,” said James Priest, MD, assistant professor of pediatric cardiology. “But for simple issues, we think once you close the hole or fix the valve, those patients are good to go.”

The research findings suggest that the medical community should monitor adults born with even minor heart defects more carefully. Medications and lifestyle changes can help prevent or delay major heart disease, such as heart attack, stroke, heart failure, and atrial fibrillation.

An article describing the research will be published on February 28 in Traffic. Priest is the main author; Priyanka Saha, a Harvard Medical School student who was a Stanford Scholar from 2017 to 2018, is the lead author.

Most common congenital condition

About 1% of infants are born with heart defects, the most common congenital disease. Those with less complex defects, such as a hole in the heart or a faulty valve, almost always survive into adulthood, sometimes unaware of the defect until later in life.

To conduct their research, Priest, Saha and their colleagues pulled data from the UK Biobank, which includes health data from 500,000 UK residents aged 37 to 73 during the biobank’s recruitment period from 2006 to 2010. They found 2,006 people with mild congenital heart defects. .

For reasons the researchers don’t understand, members of this group were slightly more likely to be obese, smoke, have high blood pressure and have diabetes – all factors that increase the risk of problems. cardiovascular.

However, even after adjusting for these risk factors, they found that people born with mild heart defects were 13 times more likely to develop heart failure or atrial fibrillation, five times more likely to have stroke, and twice as likely to suffer a heart attack. than those born without heart defects.

Adult survivors of congenital heart defects with fewer risk factors for heart disease — such as smoking, high blood pressure and obesity — fared better than those with more risk factors. People with a heart-healthy lifestyle were about a third less likely to develop heart problems than those with five or more heart disease risk factors.

A mystery

It’s unclear why adults born with heart defects suffer more heart disease, the study found. The researchers suggest several possibilities, including the stress of surgery, genetic predisposition and cellular dysfunction.

“Is it the surgery? Could it be the drugs? Or is it something intrinsic to congenital heart disease? We don’t know,” Priest said, adding, “We don’t know why infants have congenital heart disease to begin with.”

Saha said further research into why congenital heart disease leads to heart problems in adults could help shape follow-up care. But doctors can start helping these patients right away with increased monitoring.

“That’s something that can change right now,” she said. “We can start connecting them with cardiology specialists.”

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Material provided by Stanford Medicine. Original written by Mandy Erickson. Note: Content may be edited for style and length.