Eating disorders and cardiovascular outcomes: A systematic review with meta-analysis

• Cristiane Buzanello-Donin ^[1] ; Monica Augusta Mombelli ^[2] ; Marcia Rosangela Buzanello ^[3] ; Clenise Maria Reis Capellani dos Santos ^[4] ; Cassia Cristina Paes de Almeida ^[1] ; Rogerio da Luz ^[1] ; Miguel Morita Fernandes-Silva ^[1]
  1. [1] Universidade Federal do Paraná

     Universidade Federal do Paraná

     Brasil

     
  2. [2] Latin American Institute of Life and Nature Sciences, Federal University of Latin American Integration (UNILA), Foz do Igua¸cu, Parana, Brazil
  3. [3] Postgraduate Program in Applied Health Sciences, Western Parana State University (UNIOESTE), Cascavel, Parana, Brazil
  4. [4] Western Parana State University, Foz do Igua¸cu, Parana, Brazil

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 39, Nº 2, 2025
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2024.100274
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• Resumen

  • Background and objective: To conduct a literature review to assess the association between eat- ing disorders (ED), cardiovascular outcomes and all-cause mortality.

    Methods: Observational studies that presented a measure of association between mortality (or cardiac outcomes) and EDs in adult or adolescent patients were included. The databases PubMed, Web of Science, EMBASE, Livivo, Scopus, PsycINFO and Lilacs were consulted. The ran- dom effect was adopted to group the findings of the primary studies in the meta-analysis using the Hazzard Ratio (HR) as a measure of association.

    Results: The meta-analysis with 50,263 patients with ED showed a higher risk of mortality from all causes in patients compared to controls. The associated risk of death from all causes was higher with anorexia (AN) compared to other ED (AN: HR 5.38; 95 %CI 4.42 to 6.56; binge ED: HR 2.48; 95 %CI 1.13 to 5.46; bulimia: HR 2.21; 95 %CI 1.70 to 2.87). Additionally, one study demon- strated an association between bulimia and an increased risk of developing cardiovascular dis- ease (HR 4.25; 95 %CI 2.98 to 6.07) and another study showed a higher risk of cardiovascular events in people with bulimia than in healthy controls (HR 1.4; 95 %CI 0.7 to 2.8). Finally, a higher risk of cardiovascular events in people with AN (HR 10.4; 95 %CI 2.6 to 41.6) was demon- strated in one study, when compared to healthy controls.

    Conclusions: There is an association between EDs and all-cause mortality, with AN being associ- ated with the highest risk, followed by binge ED and bulimia