A recent Australian-led study analysed data from thousands of participants to conclude that being constipated may be more than just an uncomfortable condition-- it could also mean that you are more likely to experience a heart attack, stroke, or heart failure compared to those without constipation.

Large population studies have shown a correlation between constipation and increased heart attack risk in the past too. For instance, an Australian study from last year of over 540,000 hospitalized individuals aged 60+ found constipated patients had higher rates of hypertension, heart attacks, and strokes compared to non-constipated counterparts. Similar results have also been observed in other studies such as this 2020 Danish study which included more than 900,000 people from hospitals and outpatient clinics.

However, these studies left some questions unanswered, such as whether the relationship held true for healthy individuals outside hospitals and how blood pressure medications, which can cause constipation, might affect the results.

The current study, which was led by Monash University researchers, used data from the UK Biobank, which includes health information from about 500,000 UK residents, to identify over 23,000 cases of constipation and address some of these concerns. The study accounted for blood pressure medication effects and found constipated individuals were twice as likely to experience a heart attack, stroke, or heart failure compared to those without constipation. People with both hypertension and constipation had a 34% higher risk of a major cardiac event than those with hypertension alone.

While this study focused on people of European ancestry, other research suggests the link may apply to diverse populations. A Japanese study of over 45,000 individuals found those with less frequent bowel movements had a higher risk of dying from heart disease.

Several theories attempt to explain how constipation might lead to heart attacks. Straining during bowel movements can cause blood pressure spikes, which may be particularly problematic for older adults with less elastic blood vessels. Chronic constipation may be associated with impaired vagus nerve function, affecting heart rate and blood pressure regulation. Gut bacteria imbalances in constipated individuals could lead to inflammation and increased arterial stiffness. The study also identified shared genetic factors underlying both constipation and heart disease.

Given that constipation affects approximately 19% of the global population aged 60 and older, addressing this issue could significantly impact heart health. Management strategies include dietary changes, especially increased fiber intake, regular physical activity, proper hydration, and medication when necessary. These approaches may help improve bowel function and potentially reduce heart disease risk.