REVIEW article
Front. Cardiovasc. Med.
Sec. Cardiovascular Epidemiology and Prevention
This article is part of the Research TopicInfluence of Lifestyle on Cardiometabolic DiseasesView all 7 articles
Association Between Constipation and Risk of Coronary Heart Disease: A Systematic Review and Meta-Analysis of Cohort Studies
Provisionally accepted
- 1Department of Gastroenterology, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China
- 2Department of Cardiology, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China
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Objective: This systematic review and meta-analysis aimed to evaluate the association between constipation and risk of coronary heart disease (CHD). Methods: We systematically searched PubMed, Web of Science, and Cochrane Library until February 28, 2025. Published cohort studies reporting quantitative association measures for CHD in constipated versus non-constipated individuals were included. The heterogeneity was assessed via the chi-square test based on Cochrane Q statistics. I²>50% or Q-test P<0.05 indicated substantial heterogeneity, warranting random-effects modeling; otherwise, fixed-effects models were implemented. Subgroup evaluations were conducted for study design type, region, category of CHD, follow-up duration, and gender. Results: Nine studies involving 283,070 constipation cases and 3,343,120 controls were analyzed. Constipation was associated with a 10% increased CHD risk (HR=1.10, 95% CI:1.05–1.15). Statistical heterogeneity (I²=42.5%, P=0.03) was observed in the present study. Subgroup analyses revealed a stronger association with myocardial infarction (HR=1.14, 95% CI:1.05–1.23). Notably, constipation showed no CHD risk elevation in women (HR=1.04, 95% CI:0.98–1.11), with reduced residual heterogeneity (I²=30.2%, P=0.177). Conclusion: Our meta-analysis identified a significant positive association between constipation and CHD risk, particularly myocardial infarction. These findings suggest that constipation may either accelerate the pathological processes underlying CHD or that both conditions share common etiological pathways, warranting further mechanistic and interventional studies.
Keywords: Constipation, coronary heart disease, Myocardial Infarction, Cohort Studies, Meta-analysis
Received: 04 May 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Tang, Zhao, Dong, Sun, Sun and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Feng Tang, fengtang166@126.com
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